急进高原人群血清炎性细胞因子改变及抑郁发生情况分析

Analysis of the changes of inflammatory cytokine and its relationship with depressionafter fast enterin-gplateau

目的探讨急进高原人群血清炎性细胞因子水平变化情况及其与抑郁发生的相关性。方法将2015年4月至2016年5月由平原(500米以下)乘飞机急进高原(拉萨,海拔3658米)的健康中青年320例纳入观察组,选择同期平原(第三军医大学新桥医院体检中心,海拔413米)健康体检者60例纳入对照组。将观察组中抑郁自评量表(self-rating depression scale,SDS)评分≥50分者纳入高原抑郁组,SDS<50分者纳入高原无抑郁组,比较各组研究对象血清白介素(interleukin,IL)-1β、IL-6、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及γ-干扰素(interferon-γ,IFN-γ)水平,并分析其与高原抑郁组研究对象抑郁程度的相关性。结果观察组有效调查人数共309例,其中36例SDS评分≥50分,抑郁发生率为11.65%,轻度抑郁22例,中度抑郁9例,重度抑郁5例。高原抑郁组和高原无抑郁组研究对象IL-1β、IL-6、TNF-α及IFN-γ水平均显著高于对照组(P<0.05);高原抑郁组研究对象IL-1β、IL-6、TNF-α及IFN-γ水平均显著高于高原无抑郁组(P<0.05)。随着急进高原者抑郁程度的加重,IL-1β、IL-6、TNF-α及IFN-γ水平随之升高(P<0.05);Pearson相关分析提示,IL-1β、IL-6、TNF-α及IFN-γ水平与急进高原者抑郁程度呈正相关,相关系数分别为0.582、0.319、0.721、0.461(P<0.05)。结论由平原急进高原后,高原缺氧可导致炎性细胞因子水平升高,因此应及时改善急进高原人群的缺氧状态,以降低抑郁的发生率,减轻抑郁程度。

Objective To investigate the changes of inflammatory cytokine and its relationship with depression after fast entering plateau. Method 320 young healthy persons flies at plateau （Lasa, at altitude of 3658 meters） from April 2015 to May 2016 were enrolled into observation group, 60 healthy subjects from plain （Xinqiao Hospital, the Third Military Medical University, 413 meters above sea level） were selected as control group. According to the self-rating depression scale （SDS） observation group patients were divided into depression group （SDS score ≥50 points） and non-depression group （SDS score 〈 50 points）. Compared the levels of IL-1β, IL-6, TNF-α, IFN-γ among the three groups, and analyzed its correlation with the degree of depression in depression group. Result The effectively investigated in observation group were 309 cases, 36 cases of subjects＇ SDS score ≥ 50 points, the incidence of depression was 11.65%, there were 22 cases of mild depression, 9 cases of moderate depression, 5 cases of severe depression. The levels of IL-1β, IL-6, TNF-α, IFN-γ in depression group and non-depression group were significantly increased than that of control group （P 〈 0.05）. The levels of IL-1β, IL-6, TNF-α, IFN-γ in depression group were significantly increased than that of non- depression group （P 〈 0.05）. Pearson correlation analysis showed that the levels of IL-1β, IL-6, TNF-α, IFN-y were positively correlated with depression levels （P 〈 0.05）, the correlation coefficients were 0.582, 0.319, 0.721,0.461. Conclusion Plateau hypoxia can lead to inflammatory cytokine production increasing after fast entering plateau, hypoxia should be improved in a timely to reduce the incidence of depression and depression degree.