摘要
目的:探讨文拉法辛治疗前后重性抑郁障碍(major depressive disorder,MDD)患者血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、白介素-6(interleukin6,IL-6)水平的变化。方法:纳入35例MDD患者(患者组)和30名种族、性别、年龄、BMI、利手、受教育程度等匹配的健康对照者(对照组)。使用17项汉密尔顿抑郁量表(Hamilton depression scale,HAMD-17)和杨氏躁狂量表(Young manic rating scale,YMRS)评估患者情绪改变,以及文拉法辛治8周后的疗效。采用免疫比浊法测定血清hs-CRP水平,采用酶联免疫吸附实验测定血清TNF-α及IL-6水平。采用t检验比较患者组与对照组间炎性细胞因子水平的差异,对患者组治疗前后炎性细胞因子水平的变化与临床症状关系进行偏相关分析。结果:MDD组治疗前血清hs-CRP、TNF-α、IL-6的水平与对照组相比差异无统计学意义(P>0.05);治疗后HAMD-17评分[(5.63±2.81)分]较治疗前明显降低[(22.49±4.48)分,t=14.40,(P<0.01)],但仍高于对照组[(3.15±1.11)分,t=3.681,(P<0.01)]。患者治疗后血清hs-CRP[(0.37±0.43)mg/L,(0.88±0.97)mg/L,t=3.097,P=0.006]、TNF-α[(16.30±6.14)ng/L,(47.30±24.00)ng/L,t=6.495,P<0.001]及IL-6水平[(4.70±2.30)ng/L,(6.47±4.07)ng/L,t=4.758,P<0.001]显著低于治疗前。MDD组治疗后血清hs-CRP(t=-3.521,P<0.05)、TNF-α(t=-7.744,P<0.001)及IL-6(t=-3.337,P<0.05)水平明显低于对照组。使用偏相关分析控制年龄、BMI后,MDD组治疗前后TNF-α水平均与病程呈显著负相关(r=-0.784,P=0.012;r=-0.658,P=0.020)。结论:文拉法辛治疗可显著降低MDD患者血清TNF-α、IL-6、hs-CRP水平,提示神经炎性状态的改变可能参与了文拉法新的抗抑郁治疗的机制。
Objective:To explore the changes of serum hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor levels of alpha(TNF-α)and interleukin-6(IL-6)in patients with major depressive disorder(MDD)before and after venlafaxine treatment.Methods:Thirty-five MDD patients(MDD group)and thirty ethnic origin,gender,age,BMI and education level matched healthy controls(HC group)were recruited.The 17-item Hamilton depression scale(HAMD-17),Young manic rating scale(YMRS)were used to evaluate mood changes and therapeutic effect.The level of serum hs-CRP was detected by immunoturbidimetry,and the contents of serum TNF-αand IL-6 were measured by Elisa.The changes of serum hs-CRP,TNF-α,IL-6 in MDD patients before and after monotherapy(venlafaxine)treatment for 8 weeks and the differences of inflammatory cytokines between the MDD group and HC group were analyzed by t test,and partial correlation analysis was used to analyze the relationship between the changes of inflammatory cytokines and clinical symptoms in patients before and after treatment.Results:Before treatment,there were no significant differences of serum hs-CRP,TNF-αand IL-6 between MDD group and HC group(P>0.05).After treatment for 8 weeks,the score of HAMD-17 in MDD group was significantly decreased compared with that in pretreatment((5.63±2.81),(22.49±4.48),t=14.40,P<0.01),however were still higher than that in HC group((3.15±1.11),t=3.681,P<0.01).Serum levels of hs-CRP((0.37±0.43)mg/L,(0.88±0.97)mg/L,t=3.097,P=0.006),TNF-α((0.37±0.43)ng/L,(0.88±0.97)ng/L,t=3.097,P=0.006)and IL-6((4.70±2.30)ng/L,(6.47±4.07)ng/L,t=4.758,P<0.001)in post-treatment were significant lower than those in pretreatment for MDD patients.Serum level of hs-CRP(t=-3.521,P<0.05),TNF-α(t=-7.744,P<0.001)and IL-6(t=-3.337,P<0.05)in post-treatment MDD group were significantly lower than those in HC group.After controlling for age and BMI,partial correlation analysis showed that TNF-αlevel was negatively correlated with duration of disease in the MDD group before(r=-0.784,P=0.012)and after treatment(r=-0.658,P=0.020).Conclusion:Venlafaxine can reduce serum TNF-α,IL-6 and hs-CRP levels in patients with MDD,suggesting that changes in inflammatory cytokines may be involved in the mechanism of antidepressant therapy by venlafaxine.
作者
陈丽萍
潘集阳
Chen Liping;Pan Jiyang(Department of Psychiatry,Guangzhou First Peopled Hospital(The Second Affiliated Hospital of South China University of Technology),Guangzhou 510180,China;Department of Psychiatry,The First Affiliated Hospital,Jinan University,Guangzhou 510630,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2020年第7期607-612,共6页
Chinese Journal of Behavioral Medicine and Brain Science
基金
广州市卫生和计划生育科技项目(20181A011005
20182A010010)
广东省自然科学基金项目(2013B022000076)。
关键词
重性抑郁障碍
炎性细胞因子
文拉法辛
Major depressive disorder
Inflammatory cytokine
Venlafaxine
