血清Th1/Th2细胞因子在首发抑郁症患者中表达及其与患者病情程度和认知功能的关系

Expression of serum Th1/Th2 cytokines in patients with first-episode depression and its relationship with disease severity and cognitive function

目的 探讨血清辅助性T细胞1(Th1)/辅助性T细胞2(Th2)细胞因子在首发抑郁症患者中的表达及二者与患者病程程度和认知功能的关系。方法 选取2018年3月至2021年10月商丘市第二人民医院精神科收治的首发抑郁症患者75例为研究对象,同期选取本院健康体检且精神状态正常者75例为对照组。酶联免疫吸附法(ELISA)检测两组受试者血清Th1细胞因子干扰素γ(IFN-γ)、Th2细胞因子白介素4(IL-4)的水平。采用汉密尔顿抑郁量表-24(HAMD-24)评估抑郁症患者抑郁情况,根据评分将患者分为轻度抑郁19例,中度抑郁38例,重度抑郁18例。简易智力状态检查量表(MMSE)对抑郁症患者认知功能进行评估,根据MMSE评分将患者分为认知功能正常组(MMSE≥26分)43例,认知功能损伤组(MMSE<26分)32例。Pearson法分析抑郁症患者血清IFN-γ、IL-4水平与患者HAMD-24、MMSE评分间的关系;logistic回归分析影响抑郁患者认知功能损伤的危险因素。结果 与对照组比较,抑郁症组血清IFN-γ水平显著升高,IL-4水平显著降低(P<0.05);随着病情程度的增加,抑郁症患者血清IFN-γ水平逐渐升高,IL-4水平逐渐降低(P<0.05);与认知功能正常组比较,认知功能损伤组HAMD-24评分、血清IFN-γ水平显著升高,MMSE评分、IL-4水平显著降低(P<0.05);首发抑郁症患者血清IFN-γ水平与HAMD-24评分呈正相关(r=0.531,P<0.05),与MMSE评分呈负相关(r=-0.463,P<0.05);血清IL-4水平与HAMD-24评分呈负相关(r=-0.558,P<0.05),与MMSE评分均呈正相关(r=0.517,P<0.05);多因素logistic回归分析表明清IFN-γ、IL-4均与抑郁症患者发生认知功能损伤有关(P<0.05)。结论 抑郁症患者体内存在Th1/Th2细胞失衡,与患者病情程度和认知功能有关。

Objective To investigate the expression of serum T helper cell 1(Th1)/T helper cell 2(Th2) cytokines in patients with first-episode depression and their relationship with disease course and cognitive function. Methods Seventy-five patients with first-episode depression admitted to the psychiatry department of our hospital from March 2018 to October 2021 were selected as the research objects, and 75 healthy person with normal mental state were selected as the control group during the same period. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of Th1 cytokines interferon γ(IFN-γ) and Th2 cytokines interleukin 4(IL-4) in the two groups of subjects. Hamilton Depression Scale 24(HAMD-24) was used to evaluate the depression of the patients with depression. According to the score, the patients were divided into mild depression(19 cases), moderate depression(38 cases) and severe depression(18 cases). The Mini Mental State Examination Scale(MMSE) was used to evaluate the cognitive function of patients with depression. According to MMSE score, 43 patients were divided into normal group(MMSE≥26 points) and 32 patients were divided into cognitive impairment group(MMSE<26 points). Pearson method was used to analyze the relationship between serum IFN-γ, IL-4 levels and NAMD-24, MMSE scores of patients with depression;logistic regression analysis was used to analyze the risk factors of cognitive impairment in patients with depression. Results Compared with control group, the serum IFN-γ level of depression group was significantly increased, and the level of IL-4 was significantly decreased(P<0.05);with the increase of the severity of depression, the serum IFN-γ level was gradually increased, and IL-4 level was gradually decreased(P<0.05);Compared with normal cognitive function group, the HAMD-24 score and serum IFN-γ level in cognitive function impairment group were significantly increased, while the MMSE score and IL-4 level were significantly decreased(P<0.05);the serum IFN-γ level was positively correlated with HAMD-24 score(r=0.531, P<0.05), and negatively correlated with MMSE score(r=-0.463, P<0.05);the serum IL-4 level was negatively correlated with HAMD-24 score(r=-0.558, P<0.05), and positively correlated with MMSE score(r=0.517, P<0.05);multivariate logistic regression analysis showed that IFN-γ and IL-4 were related to cognitive impairment of patients with depression(P<0.05). Conclusion There is an imbalance of Th1/Th2 cells in patients with depression, which is related to the disease severity and cognitive function.