抑郁情绪对肝硬化患者血清hs-CRP、IL-1β和IL-6的影响

Effects of depression on serum hs-CRP,IL-1β and IL-6 in patients with liver cirrhosis

目的探讨抑郁情绪对肝硬化患者血清高敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)的影响,并分析抑郁情绪与疾病严重程度的相关性。方法纳入肝硬化患者84例,通过汉密尔顿抑郁量表(HAMD)评估患者抑郁的严重程度,并分为抑郁组(n=53)和无抑郁组(n=31),比较两组患者的血清hs-CRP、IL-1β、IL-6水平。根据Child-Pugh分级分为A级34例、B级26例和C级24例,比较三组患者的血清hs-CRP、IL-1β、IL-6水平,并分析HAMD评分与血清炎症因子和Child-Pugh分级的相关性。结果 84例肝硬化患者中,53例(63.1%)有抑郁情绪。Child-Pugh C级患者抑郁情绪发生率明显高于Child-Pugh B级和Child-Pugh A级(P<0.05)。抑郁组患者的血清IL-6、hs-CRP水平均显著高于无抑郁组(P<0.05)。不同Child-Pugh分级患者血清IL-6、IL-1β、hs-CRP水平之间相比,差异有统计学意义(P<0.01);Child-Pugh A级患者IL-6、IL-1β、hs-CRP水平显著低于B级(P<0.05)。相关性分析显示,血清IL-6、IL-1β、hs-CRP分别与HAMD评分呈正相关(P<0.05)。HAMD评分与肝硬化疾病严重程度呈正相关(r=0.338,P=0.002)。结论抑郁情绪可能加重肝硬化患者体内的炎症反应,血清hs-CRP、IL-1β、IL-6水平升高,抑郁情绪与疾病严重程度密切相关。

Objective To investigate the effect of depression on serum high sensitivity C-reactive protein（ hs-CRP）,interleukin-1β（ IL-1β） and interleukin-6（ IL-6） in patients with liver cirrhosis and to analyze the relationship between depression and severity of disease. Methods Eighty-four patients with liver cirrhosis were included. The severity of depression was assessed by the Hamilton Depression Scale（ HAMD） score,and patients were divided into two groups： depression group（ n = 53） and non-depression group（ n = 31）. The levels of serum hs-CRP,IL-1β and IL-6 were compared between two groups. According to Child-Pugh classification,all patients were divided into three groups： ChildPugh A（ n = 34）,Child-Pugh B（ n = 26） and Child-Pugh C（ n = 24）. The levels of serum hs-CRP,IL-1β and IL-6 were compared among three groups,and the correlations of HAMD score with inflammatory factor and Child-Pugh classification were analyzed. Results Among 84 patients with liver cirrhosis,there were 53 patients（ 63. 1%） with depression. The rate of depression in the patients with Child-Pugh C was significantly higher than that with Child-Pugh A and Child-Pugh B（ P〈0. 05）. The levels of serum hs-CRP and IL-6 in the depression group were significantly higher than those in non-depression group（ P〈0. 05）. The levels of serum IL-6,IL-1β and hs-CRP among different Child-Pugh groups were statistically significant（ P〈0. 01）. Correlation analysis showed that serum IL-6,IL-1β and hs-CRP were positively correlated with HAMD score（ P〈0. 05）,and HAMD score was positively correlated with the severity of liver cirrhosis（ r = 0. 338,P = 0. 002）. Conclusion Depression may aggravate the inflammatory response in patients with liver cirrhosis,and the levels of serum hs-CRP,IL-1β and IL-6 are increased. Depression is closely related to the severity of liver cirrhosis.