抑郁症患者血清细胞因子及C反应蛋白和锌水平值得关注的变化

Serum levels of cytokine,C-reactive protein and zinc in patients with depression:changes worth paying attention to

目的:通过对轻、重型抑郁症患者血清白细胞介素6、白细胞介素1β、肿瘤坏死因子α及C反应蛋白和锌水平的测定,探讨各指标水平与抑郁症患者的可能关系。方法:选择2003-04/10河南省精神病院住院的抑郁症患者33例作为抑郁组观察对象。选择同期心身健康的洛阳荣康医院的职工23人为对照组,两组均在早晨6:30～7:30之间空腹抽取肘静脉血5mL,采用酶联免疫吸附法测定患者的血清白细胞介素6、白细胞介素1β、肿瘤坏死因子α的水平,同时采用散射比浊法测定血清C反应蛋白,化学比色法测定血清锌水平。于入组时评定汉密顿抑郁量表,总分≥24分为重型抑郁症,总分<24分为轻型抑郁症。分析抑郁症病情严重程度与汉密顿抑郁量表总分、血清白细胞介素6、白细胞介素1β、肿瘤坏死因子α,C反应蛋白、锌水平的关系。统计学分析主要采用成组资料的t检验及单因素方差分析,χ2检验,Pearson及Spearman相关分析。结果:抑郁组患者及正常对照人群均采集到血样测定,全部进入结果分析。①抑郁症组血清白细胞介素6、肿瘤坏死因子α、C反应蛋白水平显著高于正常对照组犤(8.90±5.63),(13.57±7.63)ng/L,(6.18±5.68)mg/L;(5.95±3.66),(12.87±5.34)ng/L,(2.50±1.44)mg/L;P<0.05犦。②抑郁症组血清和锌水平显著低于正常对照组犤(11.88±2.37),(13.60±1.90)μmol/L,P<0.05犦。③抑郁症血清锌与汉密顿抑郁量表中迟缓因子有显著的相关关系(r=0.351,P<0.05)。④轻、重型抑郁症患者之间的血清白细胞介素6、白细胞介素1β、肿瘤坏死因子α、C反应蛋白和锌水平5项指标差异无显著性(P>0.05)。结论:抑郁症患者血清白细胞介素6、肿瘤坏死因子α、C反应蛋白水平升高及锌水平降低可能是抑郁症患者非特异性表现,在抑郁症组女性患者血清和锌水平显著低于男性,也可能提示性别对抑郁症有一定影响。

AIM： To determine the serum levels of interleukin-6, interleukin-1 beta,tumor necrosis factor, C-reactive protein and zinc in patients with mild and severe depression, so as to investigate the possible associations between the level of each index and depressive patients,METHODS： Thirty-three depressive patients （depression group）, who were hospitalized in Henan Provincial Psychiatric Hospital between April and October 2003, and 23 emplyees （control group）, who were healthy both physiologically and psychologically, in Luoyang Rongkang Hospital at the same period were involved in this study. Fasting venous blood （5 mL） was drawn from elbow of the subjeets in both groups between 6：30 and 7：30 in the morning. The serum levels of interleukin-6, interleukin-1 beta and tumor necrosis factor were detected with enzyme-linked immune-sorbent assay,serum C-reactive protein was detected with scattered turbidimetry, and serum level of zinc was measured with chemical ehromatometry. When entering the groups, all the subjects were assessed with Hamilton depression scale, the total score of ≥ 24 points was taken as severe depression and〈 24 points as mild depression. The associations of the depressive severity with the total score of Hamilton depression scale, ±rum levels of interleukin-6, interleukin-1 beta, tumor necrosis factor, C-reactive protein and zinc were analyzed. The student t test, univariate analysis of variance, chisquare test, Pearson and Spearman correlation analysis of grouped data were used for the statistical analysis.RESULTS： The blood samples from the depressive pateitns and normal controls were all determined, and all were involved in the analysis of resuits. ① The serum levels of interleukin-6, tumor necrosis factor and C-reactive protein were significantly higher in the depression group than in the normal control group [（8.90±5.63）, （13.57±7.63） ng/L, （6.18±5.68） mg/L;（5.95±3.66）, （12.87±5.34） ng/L, （2.50±1.44） mg/L; P 〈 0.05]. ②The serum zinc level in the depression group was significantly lower than that in the normal control group [（11.88±2.37）, （13.60±1.90） μmol/L, P 〈 0.05].③ The serum zinc level of depressive patients was significantly correlated with the factor of retardation in Hamilton depression scale （r=0.351,P 〈 0.05）. ④ There were insignificant differences in the serum levels of interleukin-6, interleukin-1 beta, tumor necrosis factor, C-reactive protein and zinc between patients with mild and severe depression P 〉 0.05. CONCLUSION： The increases of serum levels of interleukin-6, tumor necrosis factor and C-reactive protein and the decrease of serum zinc level may be the nonspecific manifestations of depressive patients. The serum zinc level is significantly lower in female depressive patients thanin male ones, it is indicated that gender has certain influence on depression P 〈 0.05.