神经病理性疼痛患者合并抑郁状态时对免疫功能的影响

The effect of depression on immunity of neuropathic pain patients

目的:对神经病理性疼痛患者进行抑郁评估,并检测外周血免疫球蛋白、补体及循环免疫复合物水平,外周血T细胞的表面标志物如CD3+、CD4+、CD8+等,比较伴抑郁状态的神经病理性疼痛患者体液免疫和细胞免疫的变化,观察抑郁状态对神经病理性疼痛患者的免疫是否有影响。方法:选择我院2006至2007年符合神经病理性疼痛纳入标准的疼痛门诊及住院患者,通过Zung’S抑郁自评量表了解病人抑郁情况;采集外周静脉血测定血常规、IgA、IgG、IgM、IgE、C3、C4、循环免疫复合物(CIC)、CD3+、CD4+、CD8+T细胞。结果:入选的86位神经病理性疼痛患者中一半以上(52名占60.47%)的患者合并有不同程度的抑郁状态,其中轻度抑郁的患者29名占总抑郁患者的55.77%。白细胞总数及淋巴细胞百分比和绝对值在有无抑郁情况的神经病理性疼痛患者中有显著差异(P<0.05),抑郁的患者较无抑郁的患者显著降低,但均在正常范围内。其他白细胞种类、IgG、IgA、IgM、IgE、C3、C4、CIC、CD3+、CD4+和CD8+等,在有无抑郁情况的神经病理性疼痛患者中没有显著差异(P>0.05)。结论:神经病理性疼痛患者容易合并以轻度为主的不同程度的抑郁状态;神经病理性疼痛患者合并抑郁状态对免疫功能有轻微影响。

Objective：Observe the effect of depression on immunity of neuropathic pain patients.Methods：Patients clinically diagnosed at least by two pain physicians as neuropathic pain for more than 3 months,with the written consent to participate the clinical survey and to donate the blood for immune function test either in pain outpatient or pain ward in West China Hospital,from the year 2006 to 2007 were recruited.Zung＇s self-rating depression scales were used to assess the extent of depression.Serum IgA.IgG,IgM,C3,C4 and circulating leukocyte,CD3,CD4,CD8 T cells were detected.Results：More than half of the patients accounted for 60.47 percent had various degrees of depression,among which,patients with mild depression were accounted for 55.77 percent of the total.The leukocyte number,lymphocyte percentage and absolute lymphocytes of the neuropathic pain patients with depression were significantly lower than neuropathic pain patients with no depression（P0.05）,but were within normal range.The leukocyte number,neutrophil,lymphocytes,monocyte,IgM,C3,C4,CIC,CD3＋,CD4＋ and CD8＋ were significantly lower in the patients with neuropathic pain（P0.05）.Other types of leukocytes,IgG,IgA,IgM,IgE,C3,C4,CIC,CD3＋,CD4＋ and CD8＋ were had no significant difference in neuropathic pain patients whether with depression or not（P 0.05）.Conclusions：Neuropathic pain patients tends to attack varying degrees of depression,expecially mild depression.Depression has mild effect on immunity of neuropathic pain patients.