老年抑郁障碍患者细胞因子及免疫相关性研究

发布时间：2018-10-25 13:36

【摘要】：目的:分析抑郁障碍老年患者的血清细胞因子及免疫因子变化及与临床症状、疗效之间的关联,为其诊断、治疗及疗效评估提供可能的客观标准。方法:收集符合ICD-10中抑郁发作、单次或复发性抑郁障碍诊断标准的住院患者,年龄≥60岁,共109例。检测细胞因子、免疫因子,同时采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评估患者抑郁焦虑及各项因子分指标。在基线及治疗末4周评估完成各项检测及评估。结果:患者组治疗前白介素(interleukin,IL)-1β、IL-6、IL-10、肿瘤坏死因子(tumor necrosis factor,TNF)及治疗后IL-1β均较正常对照组高;患者组治疗后IL-6、IL-10及TNF均低于治疗前,差异均有统计学意义(P0.001或P0.05)。患者组治疗后CRF、补体C3均显著低于治疗前,Ig G及Ig M均显著高于治疗前,差异均有统计学意义(P0.001或P0.05)。基线处患者组IL-6与睡眠障碍,IL-8,IL-10与日夜变化,TNF与焦虑/躯体化、HAMA总分、精神性焦虑均正相关(P0.05或P0.001)。患者组治疗前后IL-8浓度变化与HAMD阻滞因子分减分负相关,TNF浓度变化与HAMA因子精神性焦虑减分、HAMA因子躯体性焦虑正相关(P0.05)。结论:老年抑郁障碍患者存在细胞因子介导的免疫功能异常,可能以体液免疫应答介导为主;TNF浓度变化作为判断老年抑郁障碍疗效的指标之一。
[Abstract]:Objective: to analyze the changes of serum cytokines and immune factors in elderly patients with depressive disorder and their relationship with clinical symptoms and efficacy, and to provide possible objective criteria for their diagnosis, treatment and evaluation of efficacy. Methods: 109 patients, aged more than 60 years, who met the criteria of single or recurrent depressive disorder in ICD-10 were collected. Cytokines and immune factors were detected, and (HAMD), Hamilton anxiety scale (HAMA) was used to evaluate the depression and anxiety of the patients. Complete all tests and evaluations at baseline and at the end of 4 weeks of treatment. Results: before and after treatment, the levels of interleukin,IL 1 尾, IL-6,IL-10, (tumor necrosis factor,TNF and IL-1 尾 in the patients group were higher than those in the control group, and the IL-6,IL-10 and TNF levels in the patients group were lower than those before treatment (P0. 001 or P 0. 05). After treatment, CRF, complement C3 was significantly lower than that of, Ig G and Ig M before treatment, and the difference was statistically significant (P0.001 or P0.05). There was a positive correlation between IL-6 and sleep disorder, IL-8,IL-10 and day and night change, TNF and anxiety / somatization, total HAMA score and mental anxiety in baseline group (P0.05 or P0.001). Before and after treatment, the change of IL-8 concentration was negatively correlated with the score of HAMD block factor, the change of TNF concentration was positively correlated with the score of mental anxiety of HAMA factor and the score of physical anxiety of HAMA factor (P0.05). Conclusion: there are cytokine mediated immune dysfunction in elderly patients with depressive disorder, which may be mediated by humoral immune response, and the change of TNF concentration is one of the indexes to judge the curative effect of senile depression disorder.
【作者单位】：南京医科大学附属脑科医院老年精神科;
【基金】：南京市医学科技发展项目(YKK13126)
【分类号】：R749.4

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