抑郁症患者治疗前后血清TNF-α、IL-6和IL-18水平变化

Changes of serum TNF-α,IL-6 and IL-18 levels in depressive disorder patients before and after treatment

目的探讨抑郁症患者治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)和白细胞介素18(IL-18)水平变化,进一步确认其在抑郁症发生过程中的作用。方法纳入符合《国际疾病分类(第10版)》(ICD-10)诊断标准的48例住院抑郁症患者,招募64例健康对照组。采集对照组和患者组治疗前后静脉血,采用ELISA试验检测其血清TNF-α、IL-6和IL-18水平。收集抑郁症患者既往住院次数、住院时长、病程、发病年龄、用药剂量等临床资料。采用汉密尔顿抑郁量表17项版(HAMD-17)评定患者治疗前后抑郁程度。结果治疗前,患者组血清TNF-α和IL-6水平均高于对照组[(3.40±1.46)pg/mL vs.(2.02±1.39)pg/mL,(2.54±0.69)pg/mL vs.(0.49±0.30)pg/mL,P均<0.05];血清IL-18水平低于对照组[(23.01±4.55)pg/mL vs.(35.31±5.20)pg/mL,P<0.05]。患者治疗前后血清TNF-α、IL-6和IL-18水平比较差异均无统计学意义(P均>0.05)。患者治疗前后TNF-α、IL-6和IL-18水平的变化值与既往住院次数、住院天数、病程、发病年龄、抗抑郁药剂量、HAMD-17评分均无线性相关(P均>0.05)。结论抑郁症患者的症状改善与血清TNF-α、IL-6和IL-18水平变化之间可能并不存在相关性。

Objective To investigate the changes of serum levels of tumor necrosis factor(TNF-α),interleukin-6(IL-6)and interleukin-18(IL-18)in patients with depressive disorder before and after treatment,and to certify their roles in disease development.Methods A total of 48 inpatients with depressive disorder(patient group)who met the diagnostic criteria of the international Classification of Diseases,tenth edition(ICD-10)were enrolled,and 64 healthy individuals(control group)were also recruited.Venous blood samples of both groups were collected before and after treatment.Serum TNF-α,IL-6,and IL-18 levels of all selected subjects were detected by ELISA.Clinical data such as the previous hospitalization times,length of stay,course of disease,age of onset and clinical dosage were collected.Depression status of patients was assessed using Hamilton Depression Scale-17 item(HAMD-17).Results Before treatment,TNF-αand IL-6 levels in patient group were higher than those in control group[(3.40±1.46)pg/mL vs.(2.02±1.39)pg/mL,(2.54±0.69)pg/mL vs.(0.49±0.30)pg/mL,P<0.05],and serum IL-18 level was significantly lower than that in control group[(23.01±4.55)pg/mL vs.(35.31±5.20)pg/mL,P<0.05].Serum levels of TNF-α,IL-6 and IL-18 showed no significant difference within patient group before and after treatment(P>0.05).The changes in TNF-α,IL-6 and IL-18 levels before and after treatment were not linearly correlated with previous hospitalization times,length of stay,course of disease,age of onset,clinical dosage and HAMD-17 score(P>0.05).ConclusionNo significant correlation is found between the improvement of depressive symptoms and the changes of TNF-α,IL-6,and IL-18 concentrations.