脑梗死患者Hcy、IL-1、TNF-α水平与并发抑郁状态的关系
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摘要
目的探讨脑梗死患者血清同型半胱氨酸(Hcy)、白细胞介素-1(IL-1)、肿瘤坏死因子(TNF-α)与抑郁状态的关系。方法选取2015年2月至2016年12月在本院治疗的脑梗死患者110例,检测患者血清Hcy、IL-1和TNF-α水平,同时采用汉密尔顿抑郁量表(HAMD-24)评价患者抑郁情况。结果共有34例患者并发抑郁(抑郁组),76例无抑郁(非抑郁组);抑郁组患者血清Hcy、IL-1和TNF-α水平分别为(18.11±4.22)μmol·L~(-1)、(40.22±3.81)ng·L~(-1)和(37.80±7.10)ng·L~(-1),明显高于非抑郁组患者(P<0.05);重度抑郁患者血清Hcy、IL-1和TNF-α水平分别为(23.55±2.06)μmol·L~(-1)、(57.91±3.80)ng·L~(-1)和(58.73±7.05)ng·L~(-1),明显高于中度抑郁和轻度抑郁患者(P<0.05);患者抑郁程度与血清Hcy、IL-1和TNF-α呈正相关(rs=0.611、0.523和0.552,P<0.05)。结论脑梗死后抑郁患者血清Hcy、IL-1和TNF-α明显升高,可能与脑梗死后抑郁的发生发展有一定的关系,值得进一步研究。
Objective To investigate relationship between serum homocysteine(Hcy), interleukin-1(IL-1), tumor necrosis factor(TNF-α) in patients with cerebral infarction and depression. Method Selected 110 patients with cerebral infarction in our hospital from February 2015 to December 2016, detected serum Hcy, IL-1 and TNF-α level, used Hamilton Depression Scale(HAMD-24) to assess depression. Results 34 patients were complicated with depression(depression group), and 76 patients without depression(non depression group); The depression group patients serum Hcy, IL-1 and TNF-α were(18.11±4.22)μmol·L~(-1),(40.22±3.81)ng·L~(-1) and(37.80±7.10)ng·L~(-1), significantly higher than non depression group(P<0.05); Severe depression patients with serum Hcy, IL-1 and TNF-α were(23.55±2.06)μmol·L~(-1),(57.91±3.80)ng·L~(-1) and(58.73±7.05) ng·L~(-1), was significantly higher than that of moderate depression and mild depression patients(P<0.05);The degree of depression were positive correlation with serum Hcy, IL-1 and TNF-α(rs=0.611, 0.523 and 0.552, P<0.05). Conclusion The levels of serum Hcy, IL-1 and TNF-α are significantly increased in patients with depression after cerebral infarction,may be related to the occurrence and development of depression after cerebral infarction, which is worthy of further study.
Objective To investigate relationship between serum homocysteine(Hcy), interleukin-1(IL-1), tumor necrosis factor(TNF-α) in patients with cerebral infarction and depression. Method Selected 110 patients with cerebral infarction in our hospital from February 2015 to December 2016, detected serum Hcy, IL-1 and TNF-α level, used Hamilton Depression Scale(HAMD-24) to assess depression. Results 34 patients were complicated with depression(depression group), and 76 patients without depression(non depression group); The depression group patients serum Hcy, IL-1 and TNF-α were(18.11±4.22)μmol·L~(-1),(40.22±3.81)ng·L~(-1) and(37.80±7.10)ng·L~(-1), significantly higher than non depression group(P<0.05); Severe depression patients with serum Hcy, IL-1 and TNF-α were(23.55±2.06)μmol·L~(-1),(57.91±3.80)ng·L~(-1) and(58.73±7.05) ng·L~(-1), was significantly higher than that of moderate depression and mild depression patients(P<0.05);The degree of depression were positive correlation with serum Hcy, IL-1 and TNF-α(rs=0.611, 0.523 and 0.552, P<0.05). Conclusion The levels of serum Hcy, IL-1 and TNF-α are significantly increased in patients with depression after cerebral infarction,may be related to the occurrence and development of depression after cerebral infarction, which is worthy of further study.
引文
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[2]Chen G,Bian H,Jiang D,et al.Pseudo-continuous arterial spin labeling imaging of cerebral blood perfusion asymmetry in drugna???ve patients with first-episode major depression[J].Biomed Rep,2016,5(6):675-680.
[3]Kim H,Kong E,Cheon E,et al.Association between cerebral amyloid deposition and clinical factors including cognitive function in geriatric depression:pilot study using amyloid positron emission tomography[J].Clin Psychopharmacol Neurosci,2016,14(4):378-382.
[4]蔡敏敏.脑梗死后抑郁症多因素临床分析[J].中国药物经济学,2014,12(2):412-413.
[5]高敬华,张春阳,石秋艳.老年脑梗死后抑郁与老年功能性抑郁临床特征对比分析[J].中国煤炭工业医学杂志,2014,17(8):1302-1304.
[6]韩旭庆,黎红华.高同型半胱氨酸血症与卒中后抑郁相关性的研究进展[J].脑与神经疾病杂志,2015,23(3):237-240.
[7]刘丹,赖学章,韩永凯,等.卒中后抑郁患者的认知功能与血浆同型半胱氨酸水平的关系[J].中国康复医学杂志,2013,28(1):47-50.
[8]马柯,张洪秀,王广燕,等.TNF-α在抑郁症中的作用和机制研究[J].生命科学,2015,27(5):574-581.
[9]Shen P,Hou S,Zhu M,et al.Cortical spreading depression preconditioning mediates neuroprotection against ischemic stroke by inducing AMP-activated protein kinase-dependent autophagy in a rat cerebral ischemic/reperfusion injury model[J].Neurochem,2017,140(5):799-813.
[10]Zhang X,Tang Y,Xie Y,et al.Total magnetic resonance imaging burden of cerebral small-vessel disease is associated with poststroke depression in patients with acute lacunar stroke[J].Eur J Neurol,2017,24(2):374-380.
[11]牛海玲,马琳,王廉昌,等.IL-1、IL-2、IL-6、TNF-α在脑卒中后抑郁患者血清中的表达及其临床意义[J].现代医学,2016,44(1):89-91.
[12]邱洪兵,张松林,潘癸彬,等.脑梗死后抑郁发生的危险因素调查研究[J].右江民族医学院学报,2016,38(5):490-492.
[13]屈跃军.血清细胞因子IL-1β、IL-6、TNF-α水平与脑梗死后抑郁症的相关性研究[J].国际医药卫生导报,2015,21(11):1582-1584.
[14]王海鹏,刘洁,王春雨,等.卒中亚急性期抑郁与急性期血浆同型半胱氨酸水平的相关性研究[J].中国卒中杂志,2013,8(3):183-188.
[15]朱风俊,王润润.脑梗死后抑郁与血浆同型半胱氨酸的相关性分析[J].中国实用神经疾病杂志,2013,16(12):52-53.