度洛西汀对首发抑郁症患者血清细胞因子水平的影响  

Effect of duloxetine on the levels of cytokines in patients with first-episode depression

作　　者：赵素华[1] 孔洁华[1] 杨婵娟[1] 林育华[1] 王玲芝[1] 

机构地区：[1]广州市脑科医院,广州510370

出　　处：《中华行为医学与脑科学杂志》2012年第2期158-160,共3页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的探讨首发抑郁症患者的细胞因子水平变化及度洛西汀对其的影响。方法采用酶联免疫吸附法（ELISA）检测38例抑郁症患者度洛西汀治疗前、后血清白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞介素4（IL4）、白细胞介素-10（IL-10）水平；于治疗前后进行汉密顿抑郁量表评分，进行疗效评估，并与30例健康体检者进行比较，进行统计分析。结果治疗前，首发抑郁症患者血清IL-6、TNF—α、IL-1浓度[（10．66-4-3．12）pg／ml，（77．49±3．12）pg／ml，（39．09±3．77）pg／ml]均显著高于正常对照组[（2．72±0．91）pg／ml，（37．48±5．87）pg／ml，（10．31±1．05）pg／m1]；血清IL4、IL-10浓度[（3．18±0．46）pg／ml，（102．66±20．50）pg／m1]明显低于正常对照组[（7．85±0．49）pg／ml，（181．00±33．85）pg／ml]；经度洛西汀治疗后，患者血清IL-6、TNF-α、IL-1浓度明显较治疗前有显著下降（P〈0．05），血清IL-4、IL-10浓度较治疗前显著升高（P〈0．05），但血清IL-6、TNF—α、IL-1浓度仍明显高于正常对照组（P〈0．05）。相关性分析表明，血清IL-6、TNF-α、IL-1水平与HAMD总分呈明显正相关（r分别为0．667，0．486，0．727，P〈0．01），而血清IL-4、IL-10水平则与HAMD总分呈明显负相关（r分别为-0．433，-0．269，P〈0．05，P〈0．01）。结论首发抑郁症患者存在细胞因子介导的免疫功能紊乱，度洛西汀可能通过调节细胞因子及Th1／Th2失衡发挥抗抑郁作用。Objective To explore the changes of the levels of cytokines in patients with first-episode de- pression and the effect on the levels of cytokines after the treatment with duloxetine. Methods The serum levels of interleukin 1 （ IL-1 ）, interleukin 6 （ IL-6 ） , tumor necrosis factor-alpha （ TNF-α ）, interleukin4 （ IL-4 ）, interleu- kin10（IL-10） were measured in 38 patients with depression before and after duloxetine treatment by enzyme linked immunosorbent assay（ELISA）. HAMD score were assessed at pre- treatment and post-treatment to assess curative effect. The control group was 30 healthy individuals. All data were statistiealy analyzed by SPSS. Results Before treatment,the HAMD score and the levels of serum IL-6 ,TNF-α,IL-1 in first-episode depressant patients were remarkablely higher than those in the control group （ IL-6 ： （ 10.66 ±3.12 ） pg/ml vs （ 2.72 ± 0.91 ） pg/ml ; TNF-α ： （77.49 ± 3.12 ） pg/ml vs （ 37.48 ± 5.87 ） pg/ml ; IL-1 ： （ 39.09 ± 3.77 ） pg/ml vs （ 10.31 ± 1.05 ） pg/ml ）, the levels of serum IL-4 and IL-10 in first-episode depressant patients were remarkablely lower than those in the control group （P 〈 0.05, P 〈 O. 01 ）. The HAMD score and the levels of serum IL-6,TNF-α, IL-1 in post-treatment were re- markablely lower than pre-treatment （P〈 0.05 ）, but which were still higher than the control group（P〈 0.05 ）. The levels of serum IL-4 and IL-IO in post-treatment were remarkablely increased than pre-treatment （P 〈 O. 05 ）. The levels of serum IL-6,TNF-α, IL-1 were positively correlated with the HAMD score（ r = 0. 667,0. 486,0. 727, P 〈 O. 01 ） ,but the levels of serum IL-4 and IL-10 were negatively correlated with the HAMD scorae （ r= -0. 433, - 0. 269, P 〈 0.05, P 〈 0.01 ）. Conclusions The first-episode depressant patients show immune disorder in- duced by cytokines. Anti-depressant activity of duloxetine may participate in the regulation of cytokines and Th1/ Th2 unbalance.

关 键 词：度洛西汀 抑郁症 细胞因子 

分 类 号：R692.5[医药卫生—泌尿科学]