【摘要】：目的:分析抑郁障礙老年患者的血清細(xì)胞因子及免疫因子變化及與臨床癥狀、療效之間的關(guān)聯(lián),為其診斷、治療及療效評估提供可能的客觀標(biāo)準(zhǔn)。方法:收集符合ICD-10中抑郁發(fā)作、單次或復(fù)發(fā)性抑郁障礙診斷標(biāo)準(zhǔn)的住院患者,年齡≥60歲,共109例。檢測細(xì)胞因子、免疫因子,同時采用漢密爾頓抑郁量表(HAMD)、漢密爾頓焦慮量表(HAMA)評估患者抑郁焦慮及各項因子分指標(biāo)。在基線及治療末4周評估完成各項檢測及評估。結(jié)果:患者組治療前白介素(interleukin,IL)-1β、IL-6、IL-10、腫瘤壞死因子(tumor necrosis factor,TNF)及治療后IL-1β均較正常對照組高;患者組治療后IL-6、IL-10及TNF均低于治療前,差異均有統(tǒng)計學(xué)意義(P0.001或P0.05)。患者組治療后CRF、補(bǔ)體C3均顯著低于治療前,Ig G及Ig M均顯著高于治療前,差異均有統(tǒng)計學(xué)意義(P0.001或P0.05)�；�處患者組IL-6與睡眠障礙,IL-8,IL-10與日夜變化,TNF與焦慮/軀體化、HAMA總分、精神性焦慮均正相關(guān)(P0.05或P0.001)�；颊呓M治療前后IL-8濃度變化與HAMD阻滯因子分減分負(fù)相關(guān),TNF濃度變化與HAMA因子精神性焦慮減分、HAMA因子軀體性焦慮正相關(guān)(P0.05)。結(jié)論:老年抑郁障礙患者存在細(xì)胞因子介導(dǎo)的免疫功能異常,可能以體液免疫應(yīng)答介導(dǎo)為主;TNF濃度變化作為判斷老年抑郁障礙療效的指標(biāo)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.
【作者單位】： 南京醫(yī)科大學(xué)附屬腦科醫(yī)院老年精神科;
【基金】：南京市醫(yī)學(xué)科技發(fā)展項目(YKK13126)
【分類號】：R749.4

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