血清色氨酸水平与终末期肾病患者抑郁的关系  

Association of depression with kynurenine in end-stage renal disease

作　　者：崔梦笔 钟玲[1] 

机构地区：[1]重庆医科大学附属第二医院肾内科,400010

出　　处：《临床精神医学杂志》2015年第5期329-331,共3页Journal of Clinical Psychiatry

摘　　要：目的:探讨终末期肾病患者抑郁发生与色氨酸及其代谢产物水平之间的关系。方法:将94例行维持性血液净化治疗的终末期肾病患者纳入研究,选取25名健康志愿者为对照组,以贝克抑郁量表(BDI)评分,将终末期肾病检测患者分为抑郁组(≥14分)和非抑郁组(<14分)。检测几组的血清白细胞介素-6(IL-6)、色氨酸、犬尿氨酸、以及常规生化指标。结果:终末期肾病患者的IL-6、犬尿氨酸水平明显高于对照组(P<0.01),色氨酸水平明显低于对照组(P<0.01)。在94例透析患者中,抑郁组19例,非抑郁组75例;发生率为20.2%。抑郁组的血红蛋白、色氨酸水平明显低于非抑郁组(P<0.05),IL-6、犬尿氨酸水平明显高于非抑郁组(P<0.05)。终末期肾病患者BDI评分与IL-6、犬尿氨酸水平呈正相关(分别为r=0.294,P=0.004;r=0.217,P=0.038),犬尿氨酸与IL-6水平呈正相关(r=0.244,P=0.019)。结论:炎症介质升高可能使犬尿氨酸水平增加,色氨酸水平下降,导致终末期肾病患者发生抑郁。Objective： To examine the relationship between depression and degradation of tryptophan in patients with end-stage renal disease （ESRD）. Method：Ninty four patients with ESRD on maintenance he- modialysis were included,25 healthy volunteers as the control group. Each patients received 21-item Beck de- pression inventory（BDI） questionnaire to determine the presence or absence of depression. Biochemical parame- ters and tryptophan, kynurenine, interlerkin-6 （IL-6） were examined. Results： The levels of serum IL-6 and kynurenine were higher （ P 〈 0.01 ） while the level_s of serum tryptophan were lower （ P 〈 0. 01 ） in patients with ESRD than those in healthy control group. The prevalence of depression （ BDI 〉 14） in patients with ESRD was 20.2%. The levels of hemoglobin and tryptophan were lower （P 〈 0. 05 ） and the levels of IL-6 and kynureninein were higher （P 〈 0.05 ） in depressive patients with ESRD than those in non-depressive patients with ESRD. The levels of IL-6 and kynurenine had positive correlation significantly with BDI scores （ r = 0. 294, P = 0. 004 ; r = 0. 217, P = 0. 038 ）. The levels of kynurenine had positive correlation significantly with the levels of IL-6（r =0. 244,P =0. 019）. But the BDI scores had no significant correlation with hemoglobin and trypto- phan. Conclusion： The levels of IL-6 and kynurenine have positive correlation significantly with BDI scores. The increased kynurenine levels induce production of depression.

关 键 词：终末期肾病 抑郁 炎症 色氨酸 犬尿氨酸 

分 类 号：R749[医药卫生—神经病学与精神病学]