血清sTNFR1，sIL-2Ra和IGF-1在食管癌抑郁患者护理干预中的价值

Values of Serum sTNFR-1,sIL-2 Ra and IGF-1 on Depression in Patients with Esophageal Cancer by Nursing Intervention

目的：分析血清 sTNFR-1，sIL-2Ra和 IGF-1在食管癌抑郁患者护理干预中的价值，探讨了相关血清指标取代Zung抑郁状态问卷（DSI）和汉密尔顿抑郁量表（HAMD）的可能。方法：20例经病理证实的食管癌患者纳入研究。以DSI和 HAMD评估患者抑郁情况。采用酶联免疫吸附试验（ELISA）检测血清 sTNFR1，sIL-2Ra 和 IGF-1。结果诊断为抑郁的69例患者作为研究组，其中32例患者被诊断为抑郁症；51例未出现抑郁的患者作为正常对照组。研究组血清sTNFR-1水平为2.28±0.76 ng／ml，sIL-2Ra为234.54±59.43 ng／ml，IGF-1为297.68±53.47 ng／ml，均明显高于对照组（t＝5.356～9.274，P 值均＜0.05）；在最小抑郁到严重抑郁中血清 sTNFR-1水平分别为1.92±0.42 ng／ml，2.11±0.35 ng／ml，2.33±0.46 ng／ml；sIL-2Ra为215.52±46.21 ng／ml，243.64±61.55 ng／ml，276.78±47.22 ng／ml；IGF-1为272.71±77.48 ng／ml，311.58±91.61 ng／ml，337.75±81.54 ng／ml，这些血清学指标随患者抑郁程度而增加（F＝5.084～5.283，P值均＜0.05）。结论血清 sTNFR-1，sIL-2Ra和 IGF-1水平可作为护理干预的评价指标，但需进一步临床验证。

Objective To analyze the clinical value of sTNFR-1,sIL-2Ra and IGF-1 on depression in patients with esophageal cancer by comprehensive nursing intervention and explore the possibility of serum indicators to replace DSI and HAMD. Methods 120 patients with pathologically confirmed esophageal cancer were included in the study.Zung depression status inventory （DSI）and hamilton depression rating scale （HAMD）were used to assess depression.Serum sTNFR-1,sIL-2Ra and IGF-1were detected by enzyme-linked immunosorbent assay （ELISA）.Results 69 patients were classified as anxiety and depression group,51 patients were as normal control group.There were 32 patients with depression.Serum sTNFR-1, sIL-2Ra and IGF-1 levels in study group was higher than that in the control group （P〈0.05）and these serological indexs increased from the minimal depression,mild-to-moderate depression group to severe depression group （P〈0.05）.Conclusion Serum sTNFR-1,sIL-2Ra and IGF-1 levels may be used as evaluation index of nursing intervention,but need further clini-cal validation.