巨噬细胞迁移抑制因子与慢性阻塞性肺疾病合并抑郁的相关性分析

Analysis of correlation between macrophage migration inhibitory factor and depression in COPD

目的探讨慢性阻塞性肺疾病(COPD)合并抑郁与血清巨噬细胞迁移抑制因子(MIF)、白细胞介素(IL)-6、C反应蛋白(CRP)水平的相关性。方法选取2021年1月至2022年4月在该院呼吸科就诊的69例稳定期COPD患者作为研究对象。根据汉密尔顿抑郁量表(HAMD)评分结果将69例COPD患者分为COPD合并抑郁组(HAMD评分≥7分)和COPD非抑郁组(HAMD评分<7分)。比较COPD非抑郁组与COPD合并抑郁组患者血清MIF、IL-6、CRP水平,以及慢性阻塞性肺疾病自我评估测试(CAT)评分。并进行血清MIF水平与HAMD评分及CAT评分的相关性分析。采用受试者工作特征曲线(ROC曲线)评估血清MIF、IL-6、CRP水平预测COPD患者发生抑郁的价值,采用多因素Logistic回归分析影响COPD患者发生抑郁的相关因素。结果(1)COPD非抑郁组与COPD合并抑郁组患者BMI、CAT评分、血氧分压(PO 2)、HAMD评分、合并症、受教育程度、既往1年急性加重次数比较,差异均有统计学意义(P<0.05)。(2)与COPD非抑郁组比较,COPD合并抑郁组患者血清MIF、IL-6及CRP水平均明显升高,差异均有统计学意义(P<0.05)。(3)相关性分析结果显示,COPD患者血清MIF、IL-6、CRP水平与HAMD评分均呈正相关(r=0.343、0.302、0.278,P<0.05)。(4)ROC曲线分析结果显示,血清MIF水平对COPD患者是否抑郁的预测价值最高,曲线下面积为0.818,最佳截断值为860.82 pg/mL时,预测COPD合并抑郁的灵敏度为83.9%,特异度为78.9%。(5)多因素Logistic回归分析结果显示,血清MIF水平升高、血清IL-6水平升高、血清CRP水平升高、CAT评分增加、PO 2减低、受教育程度减低是COPD合并抑郁的独立危险因素(P<0.05)。结论COPD合并抑郁患者血清MIF水平升高,其对COPD患者发生抑郁具有较高的预测价值。

Objective To investigate the correlation in the levels of macrophage migration inhibitory factor(MIF),interleukin(IL)-6 and C-reactive protein(CRP)of chronic obstructive pulmonary disease(COPD)combined with depression.Methods From January 2021 to April 2022,69 patients with stable COPD who admitted to the respiratory department of the Second Affiliated Hospital of Nantong University were selected.According to Hamilton Depression Rating Scale(HAMD),69 patients with COPD were divided into COPD with depression group(≥7 points)and COPD without depressed group(<7 points).The levels of serum MIF,IL-6,CRP and Chronic Obstructive Lung Disease Self-Assessment Test(CAT)score were compared between the two groups.The correlations between the level of serum MIF and HAMD score and CAT score were analyzed.The receiver operating characteristic(ROC)curve were used to evaluate the value of serum MIF,IL-6 and CRP levels in predicting the occurrence of depression in patients with COPD.Logistic regression analysis was used to analyze the related factors affecting the occurrence of depression in patients with COPD.Results(1)Compared with COPD without depression group,there were significant differences in Body Mass Index(BMI),CAT score,PO 2,HAMD score,complications,education level and the number of acute exacerbation in the past year in the COPD with depression group(P<0.05).(2)Compared with the COPD without depression group,the levels of serum MIF,IL-6 and CRP in the COPD with depression group were significantly higher(P<0.05).(3)Correlation analysis showed that there was a positive correlation between serum MIF,IL-6 and CRP level and HAMD score in patients with COPD(r=0.343,0.302,0.278,P<0.05).(4)ROC curve showed that serum MIF level had the highest predictive value for depression in COPD patients,area under the curve was 0.818,cut-off value was 860.82 pg/mL,and the sensitivity and specificity of predicting depression in COPD patients were 83.9%and 78.9%.(5)Multivariate Logistic regression analysis showed that the elevated MIF levels,elevated serum IL-6 levels,elevated serum CRP levels,increased CAT scores,decreased PO 2 levels,and decreased educational attainment are independent risk factors for COPD associated with depression(P<0.05).Conclusion The serum of MIF level in the COPD patients with depression is elevated,which has a high predictive value for the occurrence of depression in COPD.