抑郁症昼夜节律变化与免疫功能的关系

Relationship between diurnal rhythm and immune function in patients with depressive disorders

目的:探讨抑郁症昼夜节律的特征与细胞因子浓度的关系。方法:对符合美国精神障碍诊断和统计手册第4版重性抑郁发作诊断标准的49例患者(抑郁症组)和38名健康人(对照组),采用酶联免疫吸附法测定其早7:00和晚7:00血浆白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)及肿瘤坏死因子(TNF)的浓度,比较各指标早、晚浓度及早晚差值在抑郁症组中有晨重夕轻、无晨重夕轻和对照组之间的差异。结果:抑郁症组中不论有、无晨重夕轻,其早晨IL-1β浓度及TNF浓度均明显低于对照组(P均<0.05或P<0.01));晚间IL-6浓度均较对照组显著增高(P均<0.05),IL-2浓度较对照组显著降低(P均<0.01);IL-6浓度早晚差值均较对照组显著增大(P均<0.05)。结论:抑郁症患者在晚间存在广泛的免疫激活,血浆IL-6的昼夜节律较对照组有异常改变。

Objective： To study the relationship between characteristics of diurnal rhythm and the plasma levels of cytokine in patients with depressive disorders. Method：The plasma levels of interleukin 1β （IL- 1β） ,interleukin 2 （IL-2） ,interleukin 6 （IL-6） and tumor necrosis factor （TNF） at 7 am and 7 pm of 49 depressed patients met diagnostic criteria of DSM-Ⅳ and 38 normal controls were measured by enzyme-linked immunosorbent assays,each indexes morning-evening levels and differences were compared among the depressed groups with and without diurnal variation, and normal controls. Results：There were significant decrease in the IL-1β morning plasma level and the TNF morning plasma level for the depressed groups with and without diurnal variation compared with controls（ all P 〈 0.05 or P 〈 0. 01 ） ; IL-6 evening plasma level of the depressed groups were significantly increased compared with controls （ all P 〈 0.05 ）, IL-2 evening plasma level of the depressed groups were significantly decreased compared with controls（ P 〈 0. 01 ） ;There were significantly increased in the IL-6 level morning-evening differences for the depressed groups compared with controls. Conclusion：There are pervasive immune in the depressed patients in evening, abnormal change is observed for the diurnal rhythm of plasma IL-6 for the depressed groups compared with controls.