抗抑郁治疗对胸腔镜食管癌根治术后伴发抑郁患者细胞免疫与生活质量的影响

Effect of antidepressant therapy on cellular immunity and quality of life of patients with depression after thoracoscopic radical resection of esophageal cancer

目的探讨抗抑郁药物治疗对胸腔镜食管癌根治术后伴发抑郁患者机体细胞免疫与生活质量的影响。方法选择2015年6月至2019年3月期间我院收治的行胸腔镜食管癌根治术伴发抑郁患者186例,按随机数字表法分为治疗组与对照组各93例,治疗组患者术后进行抗抑郁治疗,对照组患者术后未给予任何抗抑郁性药物治疗,常规性给予心理疏导。应用自评抑郁量表(Self-Rating Depres-sion Scale,SDS)、生活质量综合评估问卷(Generic Quality of Life Inventory-74,GQOLI-74)评估两组患者治疗前后抑郁状态与生活质量变化情况,运用流式细胞仪检测外周血中CD_(4)^(+)以及CD_(8)^(+)亚群水平评估两组患者治疗前后机体免疫系统功能变化情况。结果治疗后,治疗组患者SDS评分较治疗前显著降低,差异有统计学意义(P<0.05),而对照组患者治疗前后SDS评分变化不明显,差异无统计学意义(P>0.05);治疗组患者抗抑郁治疗后,机体免疫系统功能指标CD_(4)^(+)以及CD_(4)^(+)/CD_(8)^(+)水平较治疗前显著升高,CD_(8)^(+)水平较治疗前显著降低,差异均有统计学意义(P<0.05),对照组患者治疗前后,CD_(4)^(+)、CD;以及CD_(4)^(+)/CD_(8)^(+)水平变化不明显,差异无统计学意义(P>0.05);治疗后,治疗组患者在机体功能、心理功能、社会功能、物质状态以及生活质量总分方面较治疗前均明显提高,差异有统计学意义(P<0.05),对照组治疗前后,患者各维度生活质量评分变化均不明显,差异无统计学意义(P>0.05)。结论抗抑郁治疗可以明显改善食管癌术后患者抑郁状况,可明显提高患者机体免疫系统功能及生活质量。

Objective To investigate the effect of antidepressant therapy on cellular immunity and quality of life of patients with depression after thoracoscopic radical resection of esophageal cancer.Methods Between June 2015 to March 2019,our hospital during the period of line thoracoscope comorbid depressive patients,186 cases of esophageal cancer radical,according to the indicator method were randomly divided into treatment group and the control group(n=93),the treatment group after surgery for antidepressant treatment,the control group did not give any postoperatively in patients with depressive drugs treatment,routine for psychological counseling.Self-rating Depression Scale SDS and Generic Quality of Life Inventory-74(GQoli-74)were used to evaluate the changes of depression status and Quality of Life in 2 groups before and after treatment.Flow cytometry was used to detect the levels of CD_(4)^(+) and CD_(8)^(+),subsets in peripheral blood to evaluate the changes of immune system function in 2 groups before and after treatment.Results After treatment,the SDS score of the treatment group was significantly lower than that before treatment,the difference was statistically significant(P<0.05),while the SDS score of the control group was not significantly changed before and after treatment,the difference was not statistically significant(P>0.05).After antidepressant treatment,CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+),levels in the immune system in the treatment group were significantly increased,and CD_(8)^(+),levels were significantly decreased,with statistical significance(P<0.05),while CD_(4)^(+),CD,and CD_(4)^(+)/CD_(8)^(+),levels in the control group were not significantly changed before and after treatment.There was no significant difference(P>0.05).After treatment,the body function,psychological function,social function,material state and total score of quality of life of patients in the treatment group were significantly improved compared with before treatment,the difference was statistically significant(P<0.05),while the score of quality of life of patients in the control group was not significantly changed before and after treatment,the difference was not statistically significant(P>0.05).Conclusion Antidepressant therapy can significantly improve the depression status of postoperative esophageal cancer patients,and improve the immune system function and quality of life.