类风湿关节炎患者氧化应激与抑郁情绪的关系  

Relationship between oxidative stress and depression in patients with rheumatoid arthritis

作　　者：张舸[1,2] 赵绵松[1,2] 夏蓉晖[1,2] 王玉华[1,2] 张国华[1,2] 

机构地区：[1]首都医科大学附属北京世纪坛医院 [2]北京大学第九临床医学院风湿免疫科,北京100038

出　　处：《北京大学学报（医学版）》2012年第2期199-203,共5页Journal of Peking University:Health Sciences

基　　金：北京市优秀人才(20081A0303100105);首都医科大学附属北京世纪坛医院(北京大学第九临床医学院)基金(2011-C11)资助~~

摘　　要：目的:探讨类风湿关节炎患者氧化应激状态与抑郁情绪之间的关系。方法:用Hamilton抑郁量表、Zung自测抑郁量表、Zung自测焦虑量表、SCL-90(symptom checklist 90)症状量表及多项目问卷对129名类风湿关节炎患者进行调查评估,20例正常人作为对照组,在进行治疗前检测血浆氧化应激指标。根据Hamilton抑郁量表将类风湿关节炎患者分为抑郁组(≥20分,A组)和非抑郁组(<20分,B组),正常人作为对照组(C组)。结果:研究发现类风湿关节炎患者抗氧化酶防御能力下降。A组SDS(self-rating depression scale)评分为(59.12±10.18)分,B组SDS评分为(39.24±5.02)分,两组间比较差异有统计学意义(t=0.42,P<0.01)。A组SAS(self-rating anxietyscale)评分为(52.85±6.35),B组SAS评分为(39.24±5.02)分,两组间比较差异有统计学意义(t=1.48,P<0.01)。A组患者抗超氧阴离子自由基(antisuperoxide anion capacity,A-ASC)水平(393.76±43.35)明显低于B组(456.98±93.86)及C组(483.51±30.64)(F=3.95,P=0.03);A组患者丙二醛(malondialdehyde,MDA)水平(13.84±3.35)明显高于B组(9.42±3.52)及C组(7.86±3.21)(F=12.01,P=0.01)。Pearson相关分析示MDA与抑郁呈明显正相关(r=0.58,P<0.05),A-ASC与抑郁呈明显负相关(r=-0.30,P<0.05)。结论:类风湿关节炎患者存在氧化损伤,伴抑郁症状的患者抗氧化酶防御能力进一步减弱,提示氧化应激可能与类风湿关节炎抑郁症状的发生和发展密切相关。Objective： To investigate the relationship between oxidative stress and depression in patients with rheumatoid arthritis（RA）.Methods： In the study,129 patients with RA were assessed using the Hamilton depression rating scale（HAMD）,Zung self-rating depression scale（SDS）,Zung self-rating anxiety scale（SAS）,symptom checklist 90（SCL-90）,and other multipleitem questionnaires.Oxidative-stress-related parameters in sera and indexes of oxidative damage were monitored during a pretreatment period.The patients were divided into depression（group A,HAMD≥20） and nondepression groups（group B,HAMD20） based on an HAMD score cutoff of 20.In addition,20 healthy donors were classified as group C.Results： A statistically significant increase in SDS score was observed in group A（59.12±10.18） when compared with group B（39.24±5.02）（t=0.42,P 0.01）.A statistically significant increase was observed in SAS score in group A（59.12±10.18） in comparison with group B（39.24±5.02）（t=1.48,P0.01）.Antisuperoxide anion capacity was significantly decreased in group A（393.76±43.35） in comparison with group B（456.98±93.86） and group C（483.51±30.64）（F=3.95,P=0.03）,whereas serum malondialdehyde（MDA） levels of group A（13.84±3.35） were higher than those of group B（9.42±3.52） and group C（7.86±3.21）（F=12.01,P=0.01）.Pearson correlation analysis revealed that depression was positively correlated with MDA（r=0.58,P0.05）,but negatively with A-ASC（r =-0.30,P0.05）.Conclusion： The oxidative damage occurs in patients with rheumatoid arthritis,and lower antioxidant defences exist in depressive patients.The oxidative stress may promote the development of depression.

关 键 词：氧化性应激 关节炎 类风湿 抑郁 

分 类 号：R593.22[医药卫生—内科学]