维持性血液透析抑郁患者血清IL-1β、IL-6和TNF-α的改变及其临床意义

linical significance of serum IL-1a, IL-6 and TNF-á in maintenance hemodialysis patients with depression

目的探讨维持性血液透析(maintenance hemodialysis,MHD)抑郁患者血清部分细胞因子的改变及其临床意义。方法选择在南通大学附属吴江第一人民医院行MHD患者79例,根据汉密尔顿抑郁量表24项版本评分分为抑郁组和非抑郁组。采用酶联免疫吸附法(ELISA)测定2组患者血清白介素-1β(IL-1β)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)。结果根据汉密尔顿抑郁量表24项版本评分,MHD患者抑郁发生率57%;抑郁组与非抑郁组年龄、性别、透析时程、原发病构成、血红蛋白、血白蛋白、血肌酐水平等指标的差异无统计学意义;抑郁组血清IL-1β、IL-6水平增高,与非抑郁组比较差异有统计学意义(P<0.05),2组间TNF-α水平差异无统计学意义(P>0.05);不同抑郁程度MHD患者血IL-6水平随着抑郁程度加重而增高,血IL-6与HAMD评分值正相关(r=0.380,P=0.01),血IL-1β、TNF-α水平与HAMD抑郁评分值无相关性(P>0.05)。结论 MHD抑郁患者血IL-1β、IL-6表达水平增高,且IL-6与抑郁的严重程度具有相关性,有可能作为判断MHD患者抑郁严重程度的参考指标。

Objective To investigate the clinical significance of serum cytokines in the maintenance hemodialysis （MHD） patients with depression. Method A total of 79 MHD patients were enrolled in this study. They were evaluated for depression by Hamilton Rating Scale for Depression （HAMD）, and divided into depression group and non-depressive group. Serum levels of IL-1β, IL-6 and TNF-α were measured by enzyme-linked immunosorbent assay. Results The prevalence of depression was 57% in these MHD patients. Serum IL-1β and IL-6 were much higher in depression group than in non-depressive group （P 〈 0.05）, but serum TNF-α was indifferent between the two groups. Serum IL-6 was positively correlated with the severity of depression in MHD patients （P 〈 0.05）. Conclusion Serum IL-1β and L-6 increased in MHD patients with depression. Serum IL-6 was positively correlated with depression severity, and may be used as a prediction index for depression severity in MHD patients.