Background

Investigations have revealed the association between inflammation and post-stroke depression (PSD). However, whether the C-reactive protein (CRP) level, a biomarker of inflammation, would affect the development of PSD is still controversial.

Methods

A systematic search of databases was performed for eligible studies. Standardized Mean Difference (SMD) with 95% Confidence Interval (CI) was used to assess the association between the CRP level in the acute phase of stroke and the risk of PSD.

Results

13 cohort studies that involved 3536 participants were included. Combined results showed that compared with non-PSD patients, the CRP level of PSD patients was significantly higher on admission (SMD = 0.19, 95% CI: 0.12-0.27). A subgroup analysis by classifying the assessment time of depression showed obvious differences of the CRP levels between the PSD patients who were diagnosed more than 1 month after stroke and the non-PSD (1-3 months: SMD = 0.16, 95% CI: 0.06-0.25; >3months: SMD = 0.34, 95% CI: 0.18-0.51).

Conclusion

A higher level of CRP in the acute phase of stroke suggests an increased risk for PSD.

中文翻译：

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卒中急性期较高水平的 C 反应蛋白表明卒中后抑郁的风险增加：系统评价和荟萃分析

背景

调查揭示了炎症与中风后抑郁症 (PSD) 之间的关联。然而，炎症的生物标志物 C 反应蛋白 (CRP) 水平是否会影响 PSD 的发展仍存在争议。

方法

对符合条件的研究进行了系统的数据库搜索。具有 95% 置信区间 (CI) 的标准化平均差 (SMD) 用于评估卒中急性期 CRP 水平与 PSD 风险之间的关联。

结果

纳入了 13 项队列研究，涉及 3536 名参与者。综合结果显示，与非PSD患者相比，PSD患者入院时CRP水平显着升高（SMD=0.19，95% CI：0.12-0.27）。通过对抑郁症评估时间进行分类的亚组分析显示，卒中后 1 个月以上确诊的 PSD 患者与非 PSD 患者的 CRP 水平存在明显差异（1-3 个月：SMD = 0.16，95% CI：0.06 -0.25；>3 个月：SMD = 0.34，95% CI：0.18-0.51）。

结论

卒中急性期 CRP 水平较高表明 PSD 的风险增加。