广泛性焦虑症与抑郁症患者免疫、内分泌及单胺递质的对照研究

A controlled study of serum immunological, endocrinological and monoamine transmitter levels in patients with generalized anxiety disorder and major depression

目的探讨广泛性焦虑症(GAD)与抑郁症(MD) 患者在免疫、内分泌和单胺递质方面的差异.方法对30例GAD患者(焦虑症组)、38例MD患者(抑郁症组)在治疗(5-羟色胺再摄取抑制剂治疗6～8周)前后分别检测血清白细胞介素2(IL-2)、白细胞介素6(IL-6)、白细胞介素1β(IL-1β)、白细胞介素8(IL-8)、可溶性白细胞介素6受体(SIL-6R)、肿瘤坏死因子α(TNF-α)、皮质醇(CS)、促肾上腺皮质激素(ACTH)、肾上腺素(EPH)和去甲肾上腺素(NE)水平.选择30名年龄和性别与患者组相匹配的健康人为对照组.结果 (1)焦虑症组治疗前IL-8[(122±76)ng/L]、SIL-6R[(2 065±790)ng/L]水平均高于对照组(99±68)ng/L]、[(294±48)ng/L,IL-6水平为(1.6±0.7)ng/L,低于对照组[(5.3±2.7)ng/L],差异均有显著性意义(P<0.05); 抑郁症组治疗前IL-2[(7.7± 6.7)ng/L]、IL-8[(119±67)ng/L]、SIL-6R[(1 308±371)ng/L]水平均高于对照组,差异均有显著性意义(均P<0.05).经治疗后,焦虑症组IL-6[(4.3±1.2)ng/L]水平较治疗前升高,IL-8[(39±9)ng/L]水平较治疗前降低(P<0.05);抑郁症组IL-2[(2.4±1.2)ng/L]、IL-8[(47±15)ng/L]水平较治疗前降低(P<0.05);均接近于对照组水平(均P>0.05).(2)焦虑症组治疗前ACTH[(49±28)ng/L]、EPH[(67±45)ng/L]、NE[(470±259)ng/L]水平均高于对照组[(35±15)ng/L、(48±19)ng/L、(317±181)ng/L],差异均有显著性意义(均P<0.05);抑郁症组治疗前CS[(669±270) nmolg/L]水平高于焦虑症组治疗前[(430±181)nmol/L]和对照组[(386±118)nmol/L].经过治疗后,上述各指标均较治疗前降低(均P<0.05),均接近于对照组水平(均P>0.05).结论广泛性焦虑症与抑郁症在免疫学、内分泌和单胺递质方面的差异均有显著性.

Objective To explore the differences of serum immunological, endocrinological and calechol amine levels between patients with generalized anxiety disorder ( GAD) and major depression (MD). Methods Serum interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-1β( IL-1β) , soluble interleukin-6 receptor (SIL-6R) , tumor necrosis factor-α(TNF-α) , interleukin-8 (IL-8) , cortisol (CS) , adrenocorticotropin ( ACTH), epinephrine ( EPH ) , and norepinephrine ( NE) levels were detected in patients with GAD (n =30)and MD (n= 38) before and after treatment, and were compared with normal controls ( n = 30). Results (1) Levers of SIL-6R, IL-8 in anxious group before treatment were (2 065± 790) ng/L and (122±76 ) ng/L respectively, significantly higher than that in controls ( P < 0. 05). And levels of IL-6 were (1. 6±0. 7)ng/L, significantly lower than that in controls (P <0. 05). Levels of IL-2 [(7.7±6. 7) ng/L], SIL-6R [(1 308±371) ng/L], IL-8 [ (119±67)ng/L] in depressive group before treatment were significantly higher than that in controls ( P < 0. 05). After treatment, levels of Il-6 increased and IL-8 decreased significantly in anxious group, levels of IL-2 and IL-8 decreased significandy in depressive group, which were all equal to that in controls. (2) Levels of ACTH [ (49±28)ng/L] , EPH [ (67±45) ng/L] , NE [ (470±259) ng/L] in anxious group before treatment were significantly higher than that in controls (P <0. 05). Levels of CS [ (669±270) nmol/L] before treatment in depressive group weresignificantly higher than that in controls ( P < 0. 05 ). After treatment, these markers decreased significantly and were equal to that in controls. Conclusion There are markedly differences in immunological, endocrinological and catechol amine levels between patients with GAD and MD.