抑郁症对维持性血液透析患者炎症状态、氧化应激反应及神经营养因子水平的影响

Effect of Depression on the Inflammatory Status,Oxidative Stress and Levels of Neurotrophic Factors in Patients Undergoing Maintenance Hemodialysis

目的：探讨抑郁对维持性血液透析（MHD）患者炎症状态、氧化应激反应及神经营养因子水平的影响。方法：通过抑郁自评量表（SDS）评价100例MHD患者抑郁状态,据此将其分为抑郁组与非抑郁组,采血测定两组患者血清炎症因子（hs-CRP、IL-8、IL-1β）、氧化应激指标（MDA、SOD、TAC）及神经营养因子（BDNF）等指标。结果：抑郁组血清IL-8、IL-1β、hs-CRP、MDA水平均显著高于非抑郁组（t=4.674,5.448,7.856,3.794;P均〈0.05）,而血清SOD、Hb、Alb、BDNF水平均显著低于非抑郁组（t=-22.023,-2.857,-2.728,-10.608;P均〈0.05）;Logistic回归分析显示,MHD患者抑郁发生独立危险因素包括hs-CRP、IL-8、IL-1β、MDA（OR值分别为3.214、3.128、3.206、5.287）,保护因子包括SOD、Hb、BDNF（OR值分别为3.012、2.154、2.925）。结论：MHD患者易发生抑郁,其发生与患者炎症状态、氧化应激反应及营养状态密切相关。

Objective：To investigate the effect of depression on the inflammatory status,oxidative stress and levels of neurotrophic factors in patients undergoing maintenance hemodialysis（MHD）.Methods：The depression status of 100 patients undergoing MHD was evaluated by the Self-rating Depression Scale（SDS）,and the patients were divided into the depression group and the non-depression group according to the score.The blood of patients was collected to determine serum inflammatory factors（hs-CRP,IL-8,IL-1β）,oxidative stress indexes（MDA,SOD,TAC）and neurotrophic factors（BDNF）.Results：The levels of serum IL-8,IL-1β,hs-CRP and MDA in the depression group were significantly higher than those in the non-depression group（t=4.674,5.448,7.856,3.794;P〈0.05）,while the levels of serum SOD,Hb,Alb and BDNF were significantly lower than those in the non-depression group（t=-22.023,-2.857,-2.728,-10.608;P〈0.05）.Logistic regression analysis showed that hs-CRP,IL-8,IL-1βand MDA were independent risk factors of depression in patients undergoing MHD（OR=3.214,3.128,3.206,5.287）,and SOD,Hb and BDNF were protective factors（OR=3.012,2.154,2.925）.Conclusion：Patients undergoing MHD easily have depression,and the occurrence is closely related to inflammatory status,oxidative stress and nutritional status.