肿瘤坏死因子-α与抑郁症患者躯体疼痛症状相关性的研究

A study on the relationship between serum tumor necrosis factor-α and somatic pain in patients with depression

目的:探讨抑郁症患者血清肿瘤坏死因子-α(TNF-α)水平与伴有的躯体疼痛症状的关系。方法:对42例伴有躯体疼痛症状的抑郁症患者(研究组)和79例不伴有躯体疼痛症状的抑郁症患者(对照组)测定血清TNF-α水平,并采用汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)、视觉模拟评分(VAS)分别评估患者的抑郁症状、焦虑症状、躯体疼痛症状的程度,并进行相关性分析。结果:研究组血清TNF-α水平[(29.6±4.8)ng/L]显著高于对照组[(27.5±4.2)ng/L](t=2.491,P=0.027);经协方差分析调整影响因素后,两组血清TNF-α水平差异仍有统计学意义(F=3.855,P=0.036)。相关分析显示,研究组血清TNF-α水平与VAS评分、HAMD评分、HAMA评分呈正相关(r=0.362,P=0.018;r=0.408,P=0.006;r=0.336,P=0.038),对照组血清TNF-α水平与HAMD评分正相关(r=0.307,P=0.029)。结论:伴有躯体疼痛的抑郁症患者血清TNF-α水平增高,并可能与躯体疼痛症状的发生有关。

in patients with major depression. Method：Depressive patients with complains of somatic pain（study group,cases 42）were detected the serum level of TNF-α and their severity of depression,anxiety and pain symptoms were evaluated by Hamilton depression scale（ HAMD 24-items）,Hamilton anxiety scale （HAMA）and visual analogue scale（ VAS）respectively,and compared with depressive patients without complains of somatic pain（control group,79 cases）. Results：The serum level of TNF-α was significantly higher in study group[（29. 6 ±4. 8）ng/ L]than that in control group[（27. 5 ±4. 2）ng/ L]（ t =2. 491,P =0. 027）. In an analysis of covariance,the difference was still significant after adjusted by influencing factor（F =3. 855, P =0. 036）. There was a positive relationship between serum level of TNF-α and scores of VAS（ r = 0. 362, P =0. 018）,HAMD（r =0. 408,P =0. 006）or HAMA（r =0. 336,P =0. 038）in study group. A similar relationship between serum level of TNF-α and score of HAMD（ r = 0. 307,P = 0. 029）was detected in control group. Conclusion：The serum level of TNF-α depressive patients is significantly higher,which magbe correlated to the symptoms in pathophysiological mechanisms of somatic pain.