首发抑郁症患者西酞普兰治疗前后血清神经肽与细胞因子水平研究

The changes of serum levels of neuropeptide and cytokines before and after citalopram treatment in the depressive patients with the first episode

目的:探讨首发抑郁症患者西酞普兰治疗前后血清神经肽与细胞因子水平的变化。方法:采用放射免疫分析法检测50例首发未用药抑郁症患者西酞普兰治疗前后和40例健康对照组血清神经肽[神经肽Y(NPY)、β-内啡肽(β-EP)、胃动素(MTL)]和细胞因子[肿瘤坏死因子α(TNF-α)、胰岛素生长因子-Ⅱ(IGF-Ⅱ)]水平,用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)评估情感症状和疗效,并进行统计分析。结果:首发抑郁症患者治疗前血清β-EP(340.31±94.97)pg/ml、TNF-α(14.64±9.23)ng/ml和IGF-II(0.80±0.30)ng/ml水平较对照组均显著增高(均P<0.05),血清NPY(96.41±32.98)pg/ml水平显著低于对照组(P<0.05),药物治疗后IGF-II降低(P<0.05),NPY增加(P<0.05)。回归分析发现NPY是抑郁症的独立影响因素(P=0.012),MTL治疗前后的差值与药物疗效相关(P=0.016)。结论:首发抑郁症患者神经肽和细胞因子存在异常,低水平NPY可能是抑郁症的特征性指标,MTL水平上升可能预测疗效。

Objective：To compare the serum levels of neuropeptide and cytokines in first episode depressive patients before and after citalopram treatment. Methods：The serum levels of neuropeptide[neuropeptide Y （NPY）,β-endorphin （β-EP） and Motilin （MTL）]and cytokines[tumor necrosis factor α（TNF-α） and insulin-like growth factorsⅡ（IGF-Ⅱ）] were measured using radioimmunoassay in 50 first-episode drug-naive depressive patients before and after antidepressant treatment and 40 healthy controls. Severity of depression and treatment efficacy were assessed according to the Hamilton Depression Scale （HAMD-17） and Hamilton Anxiety Scale （HAMA）,and analyzed with the SPSS17.0 statistical package. Results：The serum levels of β-EP （340.31 ± 94.97 pg/ml）,TNF-α（14.64 ± 9.23 ng/ml） and IGF-II （0.80 ± 0.30 ng/ml） were significantly higher in first-episode drug-naive depression patients than controls （all P 〈 0.0001）,and serum levels of NPY （96.41 ± 32.98 pg/ml） in depressive patients were significantly lower than control group （P 〈 0.0001）. The serum levels of IGF-II reduced （P 〈 0.0001） after 6-week of therapy,while NPY increased （P 〈 0.05）. Regression analysis showed that the serum NPY was the important risk factor of depressive （P = 0.012）,and the change of MTL was the association factor influencing the therapeutic effect （P = 0.016）. Conclusion：The change of serum neuropeptide and cytokines may be involved in pathophysiology of the first episode depressive patients. The low serum NPY may be a potential predictive index for the depressive episode,while the increase of MTL can predict the antidepressant efficacy.