食管癌患者抑郁状态与血清瘦素、胃促生长素水平相关性分析

Correlation between the depression and serum leptin,ghrelin levels in patients with esophageal cancer

目的探讨食管癌患者抑郁状态与血清瘦素、胃促生长素水平的关系。方法选择河南省肿瘤医院放疗科2016年2月至2017年3月收治的45例成年男性食管癌患者为研究对象,根据是否合并抑郁症分为抑郁症组(n=20)和非抑郁症组(n=25);食管癌患者均接受放射治疗,合并抑郁症患者同时进行抗抑郁治疗。另选择20例健康成年男性作为对照组。检测所有受试者血清瘦素、胃促生长素水平,治疗前后采用汉密尔顿抑郁量表(HAMD)评估食管癌患者精神状态。比较2组受试者体质量、体质量指数(BMI)及激素水平等,并分析食管癌患者抑郁状态与血清瘦素和胃促生长素水平的相关性。结果非抑郁症组和抑郁症组患者治疗前后体质量、BMI均显著低于对照组(P <0. 05),抑郁症组与非抑郁症组患者治疗前体质量、BMI比较差异均无统计学意义(P> 0. 05)。抑郁症组与非抑郁症组患者治疗后体质量、BMI显著低于治疗前(P <0. 05);治疗后,抑郁症组患者的体质量、BMI显著低于非抑郁症组(P <0. 05)。非抑郁症组患者治疗前血清瘦素水平与对照组比较差异无统计学意义(P> 0. 05),治疗后血清瘦素水平显著低于对照组(P <0. 05);抑郁症组患者治疗前和治疗后血清瘦素水平均显著低于对照组(P <0. 05)。非抑郁症组患者治疗后血清瘦素水平显著低于治疗前(P <0. 05),抑郁症组患者治疗后血清瘦素水平与治疗前比较差异无统计学意义(P> 0. 05)。治疗前,抑郁症组与血清瘦素水平显著低于非抑郁症组(P <0. 05);治疗后,抑郁症组与非抑郁症组患者血清瘦素水平比较差异无统计学意义(P> 0. 05)。3组患者血清胃促生长素水平比较差异均无统计学意义(P> 0. 05)。食管癌患者精神状态与血清胃促生长素水平呈正相关(r=0. 360,P <0. 05),与血清瘦素水平呈负相关(r=-0. 412,P <0. 05)。结论食管癌患者的抑郁状态与血清瘦素水平呈负相关,与胃促生长素水平呈正相关。

Objective To study the correlation between the depression and serum leptin,ghrelin levels in patients with esophageal cancer( EC). Methods Forty-five male adult patients with EC in the Department of Radiation Oncology,Henan Cancer Hospital from February 2016 to March 2017 were chosen as study objects,the EC patients were divided into depression group( n = 20) and non-depression group( n = 25) according to whether they had depression or not. All EC patients received radiotherapy,while the patients with depression received antidepressant therapy. Twenty male healthy adult were recruited as control group. The levels of leptin,ghrelin in serum of all subjects were detected. Depression status was evaluated by hamilton depression scale( HAMD) before and after treatment. The body weight,body mass index( BMI) and hormone levels were compared between the two groups. The correlation between depression status and serum levels of leptin,gastrin were analyzed.Results The body weight,BMI of patients in depression group and non-depression group were significantly lower than those in the control group before and after treatment( P < 0. 05). There was no significant difference in the body weight,BMI of patients in depression group and non-depression group before treatment( P > 0. 05). The weight,BMI of patients in depression group and non-depression group after treatment were significantly lower than those before treatment( P < 0. 05). After treatment,the body weight,BMI of patients in depression group were significantly lower than those in non-depression group( P < 0. 05).There was no significant difference in the serum level of leptin between non-depression group and control group before treatment( P > 0. 05),but the serum level of leptin of patients in non-depressive group was significantly lower than that in the control group after treatment( P < 0. 05). The serum level of leptin of patients in depression group was significantly lower than that in the control group before and after treatment( P < 0. 05). The serum level of leptin of patients in non-depression group after treatment was significantly lower than that before treatment( P < 0. 05);there was no significant difference in the serum level of leptin of patients in depression group between after treatment and before treatment( P > 0. 05). Before treatment,the serum level of leptin of patients in depression group was significantly lower than that in non-depression group( P < 0. 05);after treatment,there was no significant difference in the serum level of leptin between depression group and non-depression group( P > 0. 05). There was no significant difference in the level of serum ghrelin among the three groups( P > 0. 05). The mental status of EC patients was positively correlated with the serum level of ghrelin( r = 0. 360,P < 0. 05) and was negatively correlated with the serum level of leptin( r =-0. 412,P < 0. 05). Conclusion Depression can change the serum levels of leptin and ghrelin in patients with EC,and appropriate antipsychotic treatment may improve the prognosis of patients by changing their body mass.