慢性失眠伴轻度认知功能障碍患者血清细胞因子IL-4和IFN-γ的变化

Changes of cytokines IL-4 and IFN-γ of serum in patients with chronic insomnia and mild cognitive impairment

目的探讨慢性失眠伴轻度认知功能障碍(mild cognitive impairment,MCI)患者血清细胞因子白介素-4(interleukin-4,IL-4)和γ干扰素(interferon-γ,IFN-γ)水平,以及慢性失眠患者认知功能与IL-4和IFN-γ的关系。方法62例慢性失眠患者,根据蒙特利尔认知功能量表(Montreal cognitive assessment,MoCA)、简易智能精神状况检查表(mini-mental state examination,MMSE)分值和认知功能减退的主诉分为MCI组(n=30)与非MCI组(n=32),进行匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、汉密尔顿抑郁量表24项版本(Hamilton depression scale,HAMD24)、汉密尔顿焦虑量表14项版本(Hamilton anxiety scale 14 item,HAMA14)评测,采用流式荧光法对患者进行血清IL-4、IFN-γ检测,进行相关分析及回归分析。结果慢性失眠伴MCI组的IL-4和IFN-γ水平明显低于非MCI组[IL-4:0.875(0.143,1.655)μg/L,1.855(0.813,2.723)μg/L;IFN-γ:0.450(0.173,1.163)μg/L,1.160(0.483,3.075)μg/L,均P<0.05],MCI组与非MCI组IFN-γ/IL-4比值、PSQI、HAMA14、HAMD24分值差异无统计学意义。IL-4与MoCA总分(r=0.318,P<0.05)、定向(r=0.324,P<0.05)、延迟回忆(r=0.368,P<0.05)呈正相关。多因素回归结果显示IL-4对慢性失眠患者是否患MCI均存在显著影响(B=2.161,OR=8.682,95%CI=2.058~36.633,P=0.003)。结论慢性失眠的认知功能与血清IL-4、IFN-γ密切相关,慢性失眠患者血清IL-4对认知具有保护作用,由此可推测细胞因子或许是慢性失眠患者认知改变的重要的病理生理环节。

Objective To investigate the characteristics of serum cytokine IL-4 and IFN-γlevels in patients with chronic insomnia with mild cognitive impairment(MCI),and to further explore the relationship between cognitive function and IL-4 and IFN-γin patients with chronic insomnia.Methods Sixty-two patients with chronic insomnia were divided into MCI group(n=30)and non-MCI group(n=32)according to the scores of Montreal cognitive assessment(MoCA),mini-mental state examination(MMSE)score and chief complaint of cognitive decline.Pittsburgh sleep quality index(PSQI),Hamilton depression scale(HAMD24)and Hamilton anxiety scale 14 item(HAMA14)were evaluated.Serum IL-4 and IFN-γwere detected by flow fluorescence,correlation analysis and regression analysis were carried out.Results The levels of IL-4 and IFN-γin MCI group were significantly lower than those in non-MCI group(IL-4:0.875(0.143,1.655)μg/L,1.855(0.813,2.723)μg/L;IFN-γ:0.450(0.173,1.163)μg/L,1.160(0.483,3.075)μg/L,all P<0.05).There was no significant difference in IFN-γ/IL-4,PSQI,HAMA14 and HAMD24 scores between MCI group and non-MCI group.IL-4 was positively correlated with the total score of MoCA(r=0.318,P<0.05),orientation(r=0.324,P<0.05)and delayed recall(r=0.368,P<0.01).The results of multivariate regression showed that IL-4 had significant effects on MCI in patients with chronic insomnia(B=2.161,OR=8.682,95%CI=2.058~36.633,P=0.003).Conclusion The cognitive function of chronic insomnia is closely related to serum IL-4 and IFN-γ,and serum IL-4 has a protective effect on cognition in chronic insomnia patients.Therefore,it can be speculated that cytokines may be an important pathophysiological link of cognitive change in chronic insomnia patients.