初发脑梗死患者同型半胱氨酸、白细胞介素-1β、肿瘤坏死因子-α水平与并发焦虑抑郁状态的相关性研究

Research on the relation between homocysteine, interleukin-1β, tumor necrosis factor-α levels in thepatients with primary cerebral infarction and anxiety and depression symptoms

目的探讨初发脑梗死患者同型半胱氨酸、白细胞介素（IL）-1β、肿瘤坏死因子（TNF）-α水平与并发焦虑抑郁状态的相关性。方法收集发生脑梗死患者98例，根据其预后将其分为脑梗死后抑郁组42例和脑梗死后非抑郁组56例，比较两组患者血清IL-1β、TNF-α水平和血浆HCY水平以及进一步的分析抑郁严重程度与血清IL-1β、TNF-α水平和血浆HCY水平的关系。结果脑梗死抑郁组患者的血清IL-1β[（39．28±4．35）ng/L]、TNF-α水平[（35．62±6．21）ng/L]和血浆HCY水平[（18．02±5．44）μmol/L]明显高于非抑郁组[分别为（18．52±3．21）、（21．24±3．83）ng/L、（10．98±2．56）μmol/L]，差异有统计学意义（P〈0．05）。Pearson相关分析结果显示抑郁患者抑郁严重程度与血清IL-1β、TNF-α水平和血浆HCY水平呈正相关（r=0．7813，P〈0．05）。结论高HCY和高I血清IL-1β、TNF-α浓度可能是脑梗死后抑郁发生的危险因素，临床上通过检测血浆HCY和血清IL-1β、TNF-α浓度水平可以在一定程度上反映抑郁的严重程度。

Objective To explore the relation between homocysteine （HCY）, interleukin （IL） -1β, tumor necrosis factor （TNF）-α levels in the patients with primary cerebral infarction and anxiety and depression symptoms. Methods 98 patients who stayed at the hospital＇ s inpatient department be tween August 2012 and October 2013with primary cerebral infarction were selected, and divided into two groups based on their prognosis ： 42 depressed patients with cerebral infarction and 56 non-depressed coun terparts. Then the serum IL-1β, TNF-αand plasma HCY levels in the patients of two groups were com pared, and the relation between the severity of depression and serum IL-1 β, TNF-α and plasma HCY lev els in the patients was further analyzed. Results The serum IL-1β[ （39. 28 ±4. 35） ng/LJ, TNF-α [ （35.62 ±6. 21 ） ng/L] and plasma HCY [ （18.02 ±.44） μmol/L] levels in the patients of the depres sion group were distinctly higher than that of non-depression group [ （18. 52 ± 3.21 ）, （21.24 ±3. 83） ng/L, （ 10. 98 ±2. 56） μmol/L], and the difference was statistically significant （ P 〈 0. 05 ）. According to Pearson relevant analysis results, the severity of depression in depression group was positively correlated with the serum IL-113, TNF-α and plasma HCY levels （r = 0. 781 3, P 〈 0. 05）. Conclusion High ser um IL-1 β, TNF-α and plasma HCY levels could be the risk factors leading to depression of patients with cerebral infarction. The clinically tested serum IL-1β, TNF-α and plasma HCY levels in part reflect the se verity of depression, and guide the clinical treatment and prognosis of patients with cerebral infarction. In addition, these levels can be used as effective clinical monitoring indexes to show the severity of depression of patients with cerebral infarction, having great value of clinical application.