抑郁症治疗早期炎症相关因子变化对艾司西酞普兰抗抑郁疗效的预测作用

Predictive effect of changes of inflammatory related factors on the antidepressant efficacy of escitalopram in the early stage of depression treatment

目的探讨抑郁症患者在艾司西酞普兰治疗早期血浆中炎症相关因子对其急性期抗抑郁疗效的预测作用。方法选取2016年1月至2018年12月在首都医科大学附属北京安定医院门诊就诊的85例抑郁症患者,均接受艾司西酞普兰治疗12周,根据12周疗效将患者分为治疗有效组和治疗无效组。采用液相悬浮芯片技术检测患者基线和治疗2周末血浆中21种炎症相关因子的水平,比较治疗有效组和治疗无效组基线至2周末的炎症相关因子变化。结果艾司西酞普兰治疗12周末,治疗有效组62例(72.94%),治疗无效组23例(27.06%)。以P<0.1作为界值,两组间从基线到2周的炎症相关因子变化存在差异者包括血浆粒-巨噬细胞集落刺激因子(P=0.078)、γ干扰素(P=0.053)、白介素17(P=0.030)、γ干扰素诱导蛋白(P=0.046)、单核细胞趋化因子1β(P=0.080)以及肿瘤坏死因子(P=0.087)。以年龄、性别、体质指数(BMI)和上述6种因子的变化值构建Logistic回归模型,结果显示受试者工作特征(ROC)曲线下面积为0.702,敏感度为0.500,特异度为0.814。结论炎症相关因子的早期变化可以预测艾司西酞普兰急性期的抗抑郁疗效,但仍有待大规模独立样本验证。

Objective To explore the role of plasma inflammatory related factors in predicting the antidepressant efficacy of escitalopram in patients with depression in the early stage of treatment.Methods A total of 85 patients with major depressive disorder(MDD),who were treated in the outpatient department of Beijing Anding Hospital Affiliatedd to Capital Medical University from January 2016 to December 2018,were treated with escitalopram for 12 weeks.According to the treatment response,the patients were divided into responders and non-responders.The liquid phase suspension chip technology was used to detect the levels of 21 inflammatory-related factors in the plasma at baseline and 2 week after treatment,and the changes from baseline to week 2 between responders and non-responders were compared.Results After 12 weeks of treatment with escitalopram,there were 62 patients(72.94%)in the respond group and 23 patients(27.06%)in the nonrespond group.The 2-week change value of plasma granulocyte-macrophage colony stimulating factor(GM-CSF)(P=0.078),interferon gamma(IFN γ)(P=0.053),interleukin 17(IL-17)(P=0.030),interferon gamma inducible protein(IP-10)(P=0.046),monocyte chemokine 1β(MCP-1β)(P=0.080)and tumor necrosis factor(TNFα)(P=0.087)were different between responders and non-responders(P<0.1).The logistic regression model which combinations of age,gender,BMI and the six factors above from baseline to 2 weeks can reflect the efficacy of escitalopram(AUC=0.702;sensitivity,0.500;specificity,0.814).Conclusions The early changes of inflammation-related factors can predict the antidepressant effect of escitalopram in acute phase,but it still needs to be verified by large-scale independent samples.