摘要
目的探讨抑郁障碍对慢性心力衰竭(CHF)患者血浆细胞因子及其预后的影响。方法选择CHF伴抑郁障碍70例(抑郁组)和CHF不伴抑郁障碍130例(非抑郁组)作为研究对象,采用Beck抑郁问卷评定抑郁症状严重程度,酶联免疫吸附法检测外周血白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和干扰素-γ(INF-γ),随访观察死亡、因心衰恶化再住院事件。结果抑郁组血清IL-1β、IL-6、TNF-α和INF-γ水平显著高于非抑郁组[分别为(22.56±6.27)ng/Lvs(18.58±5.95)ng/L;(29.96±6.23)ng/Lvs(24.43±8.40)ng/L;(20.34±4.45)ng/Lvs(16.56±5.87)ng/L和(176.79±37.89)ng/Lvs(156.39±34.01)ng/L,均P<0.01];Beck抑郁问卷积分与IL-1β、IL-6、TNF-α和INF-γ显著正相关(均P<0.01);2年随访期间抑郁组死亡率及再住院率均显著高于非抑郁组(分别为40%vs19%和79%vs61%,均P<0.01);多因素Cox回归分析结果显示抑郁障碍与CHF患者死亡独立相关(HR=1.126,P=0.000)。结论CHF患者伴抑郁血清致炎性细胞因子水平增高;抑郁可能是CHF患者预后差的独立预测因子。
Objective To investigate the influence of depressive disorder on serum cytokine level and prognosis of patients with chronic heart failure（CHF）. Methods 70 CHF patients with depressive disorder（depressive group） and 130 CHF patients without depressive disorder（ non-depressive group） were included in this study. All subjects were rated with Beck depressive inventor, （BDI）, Serum IL-1β,IL-6,TNF-α and INF-γ were determined with enzyme linked immune absorption assay. Mortality anti readmission were observed during followup. Results The level of IL-1β, IL-6,TNF-α anti INF-γ, were markedly higher in depressive group than non-depressive group（22.56 ±6.27 vs 18. 58 ±5. 95ng/L;29. 96 ±6.23 vs 24.43 ±8.40 ng/L ;20.34±4.45 vs 16.56 ±5. 87 ng/L and 176.79 ±37.89 vs 156.39 ±34.01ng/L ,respectively,all P〈 0. 01 ）. Correlation analysis result showed that BDI score was positively related to IL-1β, IL-6,TNF-α and INF-γ（ all P 〈 0.01 ）. After a fallow up period of 24 months, rates of mortality and readmissinn in depressive group was remarkably increased compared with non-depressive group（40% vs 19% , 79% vs 61% ,respectively, all P〈0.01 ）. Multivariate cox regression analysis results demonstrated that depression was significantly and independently related to the occurrence of death （ HR =1. 126, P= 0.000）. Conclusion The depressive disorder promotes produce of proinflammatory cytokines, and may be a independent predictor of poor prognosis in CHF patient.
出处
《中国行为医学科学》
CSCD
2006年第12期1081-1083,共3页
Chinese Journal of Behavioral Medical Science
关键词
抑郁
细胞因子
心力衰竭
预后
Depression
Cytokine
Chronic heart failure
Prognosis
