舍曲林与文拉法辛对首发抑郁症患者血清细胞因子水平影响的对照研究

Study on the levels of cytokines in first-episode depressant patients before and after the treatment with ser- traline and venlafaxin

目的探讨首发抑郁症患者的细胞因子水平变化以及比较不同种类的抗抑郁剂舍曲林与文拉法辛对患者血清细胞因子水平的影响。方法分别测定80例首发抑郁症患者的血清IL-2、IL-6、TNF．Ot、IL-10水平，并与40例健康对照者进行比较；80例首发抑郁症患者依抽签法分为人数相等的2组，分别经舍曲林、文拉法辛治疗6周后进行疗效评估，对舍曲林、文拉法辛治疗敏感的患者进行IL-2、IL-6、TNF-α、IL-10水平测定，并进行统计分析。结果首发抑郁症患者的血清IL-2、IL-6、TNF-α细胞因子水平[（6．79±2．89）pg／ml，（10．12±4．52）pg／ml，（14．81±4．38）pg／ml]显著高于健康对照组[（4．06±2．05）pg／ml，（6．04±1．79）pg／ml，（10．69±2．54）pg／m1]；舍曲林、文拉法辛治疗后较治疗前IL-6水平有显著降低（P〈0．05），IL-2、TNF—α、IL-10差异无显著性（P〉0．05），而舍曲林、文拉法辛两种抗抑郁剂对细胞因子水平的影响差异无显著性（P〉0．05）。结论首发抑郁症患者存在细胞因子水平的改变，并可以通过舍曲林、文拉法辛的治疗来矫正，而舍曲林、文拉法辛可能对细胞因子有相同的免疫作用机制。

Objective To detect the levels of cytokines in first-episode depressant patients and the influence on the levels of cytokines after the treatment with sertraline and venlafaxin. Methods The levels of IL-2, IL-6 ,TNF-α and IL-IO were measured in 80 first-episode depressant patients and 40 healthy control subjects. 80 first-episode depressant patients were divided into two groups which were treated by sertraline and venlafaxin respectively. The levels of the same items were measured after 6-week treatment with sertraline and venlafaxin. All data were statistically analyzed by SPSS. Results The levels of IL-2, IL-6,TNF-α in 80 first-episode depressant patients were significantly higher than that in control group （ IL-2 ： （ 6.79 ± 2.89 ） pg/ml vs （4.06 ± 2.05 ） pg/m] ; IL-6： （ 10.12 ±4.52） pg/ml vs （6.04± 1.79） pg/ml;TNF-α： （ 14.81±4.38） pg/ml vs （ 10.69 ±2.54） pg/ml） （P 〈 0.05 ）. The level of IL-6 after treatment by sertraline and venlafaxin was lower than that before treatment. There were no significant difference of the levels of IL-2, TNF-α, IL-10 before and after treatment. No significant difference of the levels of cytokines were observed between the two groups which were treated by sertraline and venlafaxin. Conclusions There are some changes of the levels of cytokines in first-episode depressant patients, which might be corrected by the treatment with sertraline and venlafaxin. Sertraline and venlafaxin might have the same mechanisms to cytokines.