氟哌噻吨美利曲辛片改善脑卒中后抑郁患者相关血清细胞因子表达水平以及感戴倾向的效果分析

Analysis of effect flupentixol and melitracen tablets on improving expression of depression related cytokines after stroke and the difference of sentiment tendency

目的探究氟哌噻吨美利曲辛片改善脑卒中后抑郁患者相关血清细胞因子表达水平以及感戴倾向的效果。方法选取115例脑卒中后抑郁患者作为观察组,另选同期进行健康体检的100例健康者作为对照组。观察组患者采用口服氟哌噻吨美利曲辛片进行治疗。采集所有研究对象的血清样本,分别采用实时定量聚合酶链式反应(PCR)检测研究对象血清微小核糖核酸(miR)21的水平,使用酶联免疫吸附测定法(ELISA)检测研究对象血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平。比较两组一般资料。比较观察组不同时间段与对照组血清miR21以及炎性细胞因子IL-6、IL-8和TNF-α水平;汉密尔顿抑郁量表(HAMD)评分;感戴倾向。分析观察组不同时间段血清miR21与炎性细胞因子IL-6、IL-8和TNF-α水平的相关性、治疗效果。结果治疗前,观察组血清IL-6、IL-8、TNF-α水平均明显高于对照组,差异具有统计学意义(P<0.05);治疗1个月后,观察组血清IL-6、IL-8、TNF-α水平均有所下降,但仍高于对照组,差异具有统计学意义(P<0.05);治疗3个月后,观察组TNF-α水平进一步下降,但仍高于对照组,差异具有统计学意义(P<0.05)。初诊时,观察组血清miR21水平高于对照组,差异具有统计学意义(P<0.05);治疗1个月和3个月后,血清miR21水平均明显降低,但仍高于对照组,差异具有统计学意义(P<0.05)。观察组初诊时血清miR21与IL-6呈正相关(r=0.668, P<0.05), miR21与TNF-α呈正相关(r=0.876, P<0.05), miR21与IL-8无明显相关性(r=0.005, P>0.05)。治疗1个月后,观察组血清miR21与IL-6和TNF-α均呈正相关(r=0.576、0.528, P<0.05), miR21与IL-8无明显相关性(r=0.003, P>0.05)。治疗前、治疗1个月后,观察组感戴深度、感戴密度、感戴频度、感戴广度评分均明显低于对照组,差异具有统计学意义(P<0.05)。治疗3个月后,观察组感戴深度、感戴密度、感戴频度、感戴广度评分与对照组基本持平,比较差异无统计学意义(P>0.05)。结论氟哌噻吨美利曲辛片能够改善脑卒中后抑郁情况,降低炎症水平。

Objective To investigate the effect of flupentixol and melitracen tablets on improving expression of depression related cytokines after stroke and the difference of sentiment tendency. Methods There were 115 post-stroke depression patients selected as observation group, and another 100 healthy people who had physical examination in the same period were selected as the control group. The serum samples of all subjects were collected, and the miR21 content in the serum was detected by real-time quantitative polymerase chain reaction(PCR) and the concentrations of interleukin-6(IL-6), interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) in the serum were detected by enzyme-linked immunosorbent assay(ELISA). The clinical data, serum miR21, levels of inflammatory cytokines IL-6, IL-8 and TNF-α, Hamilton depression scale(HAMD) score and sentiment tendency were compared between the two groups. Results Before treatment, the levels of serum IL-6, IL-8 and TNF-α in the observation group were obviously higher than those in the control group, and their difference was statistically significant(P<0.05). After 1 month of treatment, the levels of serum IL-6, IL-8 and TNF-α in the observation group were decreased, but still higher than those in the control group, and the difference was statistically significant(P<0.05). After 3 months of treatment, the levels of TNF-α further decreased, but still higher than that in the control group, and the difference was statistically significant(P<0.05). At the time of first consultation, the serum miR21 level in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). After 1 and 3 months of treatment, the serum miR21 level in the observation group was obviously declined, but still higher than those in the control group, and their difference was statistically significant(P<0.05). In the observation group, serum miR21 was positively correlated with IL-6 at the the time of first consultation(r=0.668, P<0.05), miR21 was positively correlated with TNF-α(r=0.876, P<0.05), and there was no significant correlation between miR21 and IL-8.(r=0.005, P>0.05). After 1 month of treatment, there was a positive correlation between serum miR21 and IL-6 and TNF-α in the observation group(r=0.576, 0.528, P<0.05), and there was no significant correlation between miR21 and IL-8(r=0.003, P>0.05). Before treatment and after 1 month of treatment, the sensory depth, sensory density, sensory frequency, and sensory breadth scores in the observation group were obviously lower than those in the control group, and the difference was statistically significant(P<0.05). After 3 months of treatment, the sensory depth, sensory density, sensory frequency, and sensory breadth score in the observation group were basically the same as those of the control group, and the difference was not statistically significant(P>0.05).Conclusion Flupentixomil and melitracen tablets can improve post-stroke depression and reduce the level of inflammation.