抑郁发作和复发性抑郁患者睡眠特征、炎症水平及其相关性研究

Study on Sleep Characteristics,Inflammation Level and Their Correlation in Patients with Depressive Episode and Recurrent Depression

目的探讨抑郁发作和复发性抑郁患者睡眠特征、炎症水平及其相关性。方法调查149例抑郁发作患者,174例复发性抑郁患者,检测患者血清C反应蛋白(CRP)的水平,采用匹兹堡睡眠质量量表(PSQI)评定患者睡眠情况,24项汉密尔顿抑郁量表(HAMD)评定患者抑郁情绪。结果复发性抑郁患者比抑郁发作患者起床时间更晚(t=-2.260,P<0.05),在床时间更长(t=-2.143,P<0.05),差异均有统计学意义。独立样本t检验结果表明,复发性抑郁患者CRP水平高于抑郁发作患者(t=-3.090,P<0.05),差异有统计学意义。两组患者的睡眠效率(t=-0.426,P>0.05)差异无统计学意义。多元回归模型显示,起床时间和床上时间对CRP的解释量分别为32.8%和53.5%。相关分析,无论是抑郁发作患者还是复发性抑郁患者,起床时间以及在床时间与CRP水平都呈正相关。结论相比抑郁发作患者,复发性抑郁患者起得更晚、在床时间更长、CRP水平更高,相关分析发现,抑郁症患者起得晚、睡得久长均与CRP水平升高存在显著关联。提示,睡眠特征及炎症水平可能在抑郁症复发中发挥一定作用。

Objective To investigate the sleep characteristics,inflammation level and their correlation in patients with depressive episode and recurrent depression.Methods The level of serum C-reactive protein(CRP)in 149 patients with depressive episode and 174 patients with recurrent depression were observed.The sleep status was assessed by Pittsburgh Sleep quality index(PSQI)and the depression was assessed by Hamilton Depression scale-24 item(HAM-D24).Results The patients with recurrent depression got up later(t=-2.260,P<0.05)and spent more time in bed(t=-2.143,P<0.05)than those with depressive episode,the difference was statistically significant.Independent sample t-test showed that the level of CRP in patients with recurrent depression was significantly higher than that in patients with depressive episode(t=-3.090,P<0.05).No significant difference was observed in sleep efficiency between these two groups(t=-0.426,P>0.05).Multiple regression model showed that the amount of CRP explained by wake-up time and bed time was 32.8%and 53.5%,respectively.Correlation analysis showed that the time to get up and the time in bed were positively correlated with CRP levels in both patients with depressive episode and patients with recurrent depression.Conclusion Compared with patients with depressive episode,patients with recurrent depression get up later,stay in bed longer and have higher CRP levels.Correlation analysis showed that wake up late and long sleep in patients with depressive episode were significantly associated with elevated CRP levels.It suggested that sleep characteristics and inflammatory level may play a role in the recurrence of depression.