ACTH、CORT、IL-18、TNF-α预测抑郁症的临床应用价值分析

Clinical application value of ACTH, CORT, IL-18 and TNF-α in predicting depression

目的探究促肾上腺皮质激素(ACTH)、皮质醇(CORT)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)对预测抑郁症的临床应用价值。方法选取2017年6月~2019年6月宁波市康宁医院(以下简称“我院”)首次确诊为抑郁症的60例患者作为抑郁组,另选取同期来我院进行常规体检的健康人群60名作为对照组,分别检测两组血清ACTH、CORT、IL-18、TNF-α水平,分析其与抑郁症的相关性。结果抑郁组血清ACTH、CORT、IL-18、TNF-α水平均显著高于对照组(P<0.05);血清ACTH水平与抑郁情绪、有罪感、早睡末端失眠、精神性焦虑、躯体性焦虑、日夜变化、能力减退等汉密尔顿抑郁量表(HAMD)因子及HAMD总分呈正相关(P<0.05);CORT与抑郁情绪、早睡末端失眠、工作兴趣、躯体性焦虑、体重减轻、日夜变化、偏执症状等HAMD因子及HAMD总分呈正相关(P<0.05);IL-18与抑郁情绪、入睡困难初段失眠、躯体性焦虑、全身症状、偏执症状、强迫症状、能力减退等HAMD因子及HAMD总分呈正相关(P<0.05);TNF-α与抑郁情绪、早睡末端失眠、工作兴趣、精神性焦虑、躯体性焦虑、全身症状、能力减退等HAMD因子及HAMD总分呈正相关(P<0.05)。结论抑郁症患者血清ACTH、CORT、IL-18、TNF-α水平较高,直接检测以上指标水平对预测抑郁症的发生具有一定临床应用价值。

Objective To investigate clinical application value of ACTH,CORT,IL-18 and TNF-αin predicting depression.Methods A total of 60 patients with first-diagnosis depression admitted to Ningbo Kangning Hospital(“our hospital”for short)from June 2017 to June 2019 were selected as depression group,a total of 60 healthy persons who underwent routine physical examination in our hospital during the same period were selected as the control group.Serum levels of ACTH,CORT,IL-18 and TNF-αin two groups were detected respectively to analyze the correlation with depression.Results The serum levels of ACTH,CORT,IL-18 and TNF-αin depression group were significantly higher than those in the control group(P<0.05).The serum levels of ACTH was positively correlated with total score of Hamilton depression scale(HAMD)and HAMD factors(P<0.05),such as depression,guilt,insomnia at the end of early sleep,mental anxiety,somatic anxiety,diurnal and nighttime changes,and impaired ability.CORT was positively correlated with total score of HAMD and factors(P<0.05),such as depression,insomnia at the end of early sleep,work interest,somatic anxiety,weight loss,diurnal and nighttime changes,and paranoid symptoms.The total score of HAMD was positively correlated with IL-18(P<0.05).IL-18 was positively correlated with HAMD factors such as depression,early insomnia with difficulty in falling asleep,somatic anxiety,general symptoms,paranoid symptoms,obsessive-compulsive symptoms,and impaired ability(P<0.05).TNF-αwas also positively correlated with total score of HAMD and its factors such as depression,insomnia at the end of early sleep,work interest,mental anxiety,somatic anxiety,general symptoms and impaired ability(P<0.05).Conclusion The serum levels of ACTH,CORT,IL-18 and TNF-αin patients with depression are higher.Direct detection of the above indicators has certain clinical application value in predicting the occurrence of depression.