冠心病合并抑郁症患者血清脂联素水平及其与炎性因子相关性的临床研究

Clinical Research of Serum Adiponectin Levels of Patients with Coronary Heart Disease Combined with Depression and Its Correlation with Inflammatory Factors

目的分析冠心病合并抑郁症患者血清脂联素水平及其与炎性因子的相关性。方法选用110例冠状动脉造影检查确诊的冠心病患者,根据汉密尔顿抑郁评分,分为冠心病合并抑郁症组52例和冠心病非抑郁组各58例,另外选取60例正常对照组,测定其血清脂联素(APN)、IL-6、TNF-a、hs-CRP水平。结果冠心病组患者血清IL-6(136±18.6)ng/L、TNF-a(15.6±9.5)ng/L、hs-CRP(4.6±3.1)mg/L,均显著高于对照组(P<0.01),血清APN(12.12±3.76)mg/L显著低于对照组(P<0.01);冠心病合并抑郁症患者血清IL-6(166.2±21.6)ng/L、TNF-a(18.2±12.0)ng/L、hs-CRP(10.2±3.4)mg/L显著高于冠心病非抑郁症组(P<0.01),血清脂联素显著低于对照组(P<0.01),且冠心病合并抑郁症组血清脂联素水平与炎性因子IL-6、TNF-a、hs-CRP呈显著的负相关性(r值分别为-0.560,-0.462,-0.268,P<0.01)。结论冠心病合并抑郁症组血清脂联素水平明显减低,而炎性因子IL-6、TNF-a、hs-CRP均显著增高,这些炎性因子对脂联素具有一定的抑制作用,从而增加冠心病的发病率及冠心病患者并发抑郁症的可能。

Objective To analyze the serum adiponectin levels of patients with coronary heart disease combined with depression and its correlation with inflammatory factors. Methods 110 cases of patients with coronary heart disease confirmed by coronary angiography examination were selected and divided into the coronary heart disease combined with depression group with 52 cases and the coronary heart disease without depression group with 58 cases according to the Hamilton depression score, in addition, 60 cases of normal people were selected as the control group, the levels of serum adiponectin（APN）, IL-6, TNF-a and hs-CRP were measured. Results The serum IL-6（136±18.6）ng/L, TNF-a（15.6±9.5）ng/L and hs-CRP（4.6±3.1）mg/L in the coronary heart disease group were obviously higher than those in the control group（P〈0.01）,the serum APN（12.12±3.76）mg/L in the coronary heart disease group was obviously lower than that in the control group（P〈0.01）, the serum IL-6（166.2±21.6）ng/L, TNF-a（18.2±12.0）ng/L and hs-CRP（10.2±3.4）mg/L in the coronary heart disease combined with depression group were obviously higher than that in the coronary heart disease without depression group（P〈0.01）, the serum adiponectin in the coronary heart disease combined with depression group were obviously lower than that in the control group（P〈0.01）and it also had an obvious negative correlation with the inflammatory factors IL-6, TNF-a and hs-CRP,（R values were respectively-0.560,-0.462 and-0.268, P〈0.01）. Conclusion The serum adiponectin level obviously decreases and the inflammatory factors IL-6, TNF-a and hs-CRP obviously increase in the coronary heart disease combined with depression group, these inflammatory factors have a certain inhabitation effect on adiponectin and then enhance the incidence of coronary heart disease and chances of coronary heart disease patients complicated by depression.