抑郁症患者帕罗西汀治疗前后血清细胞因子C-反应蛋白和锌水平变化的研究

The study of level changes of serum cytokine, C-reactive protein and zinc in patients with depression at pre-and post-treatment of Paroxetine

目的探讨IL-6、IL-1β、TNF-α、CRP、锌在抑郁症病理生理机制中的作用。方法抑郁症患者33例,符合CCMD-3和ICD-10诊断标准;正常对照组23例。采用酶联免疫吸附法(ELISA)测定两组血清IL-6、IL-1β、TNF-α的水平,同时采用散射比浊法测定CRP,化学比色法测定锌水平。于治疗前后评定HAMD,分析抑郁症病情严重程度、病程、发病起始年龄、性别、HAMD总分及其因子分与血清IL-6、IL-1β、TNF-α、CRP、锌水平的关系。结果1.抑郁症组治疗前血清IL-6[(8.90±5.63)pg/ml]、TNF-α[(13.57±7.63)pg/ml]、CRP[(6.18±5.68)mg/L]水平显著高于正常对照组[(IL-6:(5.95±3.66)pg/ml,TNF-α:[12.87±5.34)pg/ml],CRP:[(2.50±1.44)mg/L],血清锌水平[(11.88±2.37)mmol/L]显著低于正常对照组[(13.60±1.90)mmol/L];抑郁症组血清锌水平[(11.19±2.21)mmol/L]女性患者显著低于男性患者(14.04±1.48)μmol/L;2.抑郁症组治疗前血清锌与HAMD中迟缓因子分有显著的正相关关系(r=0.351,P<0.05);3.帕罗西汀治疗后血清IL-6、TNF-α、CRP水平较治疗前显著下降(P<0.05),血清锌水平较治疗前显著升高(P<0.01)。结论1.血清IL-6、TNF-α、CRP水平升高可能是抑郁症的免疫学标志之一;2.锌可能对抑郁症的发病有一定作用;3.帕罗西汀可能对IL-6、TNF-α、CRP、锌有一定影响。

Objective By means of measuring the level of serum cytokine （ IL-6, IL-113 and TNF-α）, Creactive protein and zinc in patients with depression at pre- and post-treatment of Paroxetine,to explore the role of these indices in the pathophysiology in depression. Methods There are 33 patients with depression according to the criteria of CCMD-3 and ICD-10,and 23 heahhy controls in our study. The level of serum IL-6,IL-1β,TNF-α by enzymatic-linked immunosorbent assay（ELISA） ,and serum CRP concentration were measured by scatter rate nephelometry,and the level of Zn by chemistry colorimetric method. And at pre- and post-treatment to assess HAMD,analyze the correlation of sever degree, course, disease onset year,gender, the total score of HAMD, the factor score and serum IL-6, IL-1β,TNF-α,CRP,Zn. Results 1. There is significant higher in the level of serum IL-6 （ 8.90±5.63 ） pg/ml, TNF-α （ 13.57±7.63 ） pg/ml, CRP （ 6. 18 ± 5.68 ） mg/L in patients with depression than those in controls [IL-6 ： （ 5.95 ± 3.66 ） pg/ml, TNF-α： （ 12.87 ± 5.34 ） pg/ml, CRP： （ 2.50 ± 1.44 ） mg/L ] , and significant lower in serum zinc level in depression （ 11.88 ± 2.37 ） than that in controls （ 13.60 ± 1.90）,significant lower in serum zinc level in female patients with depression（ 11. 19 ±2.21 ）μmol/L than male depression（ 14.04 ±1.48 ）μmol/L. 2. There is significant positive correlation in the serum Zn level and psychomotor retardation score of HAMD in depression （ r =0. 351, P〈0.05 ）. 3. Serum IL-6,TNF-α, CRP level in post-treatment is significant lower than pre-treatment in depression（ P〈 0.05 ） ; the level of serum Zn in post-treatment is significant higher than pre-treatment（ P〈 0.01 ）. Conclusions 1. The increases in the level of serum IL- 6, TNF-α, CRP may be immunological markers of depression;2. Zn can play a role in the etiopathogenesis of depression; 3. Paroxetine may affect the level of IL-6,TNF-α,CRP,Zn.