帕金森病患者血清炎性因子水平的变化与伴发抑郁症的关系  

Correlation of Serum Inflammatory Factors with Depression in Patients with Parkinson's Disease

作　　者：李志军[1] 邹为[1] 杨渊[1] Li Zhijun Zou Wei Yang Yuan(Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan 430030, Chin)

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030

出　　处：《华中科技大学学报（医学版）》2016年第6期593-596,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：教育部留学回国人员科研启动基金资助项目(教外司留[2014]1685号);华中科技大学院系自主创新研究基金资助项目(No.2016YXMS109)

摘　　要：目的探讨帕金森病(PD)患者血清炎性因子变化与伴发抑郁症的关系。方法根据汉密尔顿抑郁量表(HAMD-21)将113例PD患者分为无抑郁组和轻、中、重度抑郁组。所有患者均行PD综合评分量表第Ⅲ部分(UPDRS-Ⅲ)、Hoehn-Yahr分期量表评分,Schab&England日常活动分级评分以及简易智力检查量表(MMSE)评估PD患者病情;应用ELISA法检测血清白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)以及C反应蛋白(CRP)水平。采用Logistic回归分析血清炎性因子与PD伴发抑郁的相关性。结果 113例PD患者中伴发抑郁48例(42.5%)。PD无抑郁组和抑郁组在年龄、性别、UPDRS-Ⅲ评分、Hoehn-Yahr分期、Schab&England评分差异均无统计学意义(均P>0.05);抑郁组与无抑郁组相比,患者受教育程度低(P<0.05),病程长(P<0.01),MMSE评分低(P<0.05)。PD患者血清IL-6、IL-1β、TNF-α和CRP水平分别为(12.16±2.78)ng/L、(235.86±33.27)pg/mL、(229.77±52.98)pg/mL、(2.55±0.97)mg/L,与正常对照组相比均明显升高,差异均具有统计学意义(均P<0.01)。PD无抑郁组与PD轻、中、重度抑郁组多组间比较采用单因素方差分析,结果显示各炎症因子水平的组间差异均具有统计学意义(IL-6:F=6.52,P<0.05;IL-1β:F=35.58,P<0.01;TNF-α:F=42.27,P<0.01;CRP:F=5.47,P<0.05)。抑郁各组炎性因子含量高于正常对照组和无抑郁组(均P<0.05);而且抑郁程度越严重,炎性因子升高趋势越明显。进一步的回归分析显示,高龄、低教育水平、长病程、高炎性因子水平是PD伴发抑郁的危险因素(均P<0.05)。结论 PD抑郁患者血清IL-6、IL-1β、TNF-α、CRP显著升高。高龄、低教育水平、长病程、高炎性因子水平是PD伴发抑郁的危险因素。Objective To observe the correlation of serum inflammatory factors with depression in patients of Parkinson＇s disease（PD）.Methods In total,113 patients of PD were divided into PD without depression group,PD with mild,moderate and severe depression groups,according to the Hamilton depression rating scale-21（HAMD-21）.The unified Parkinson＇s disease rating scale-Ⅲ（UPDRS-Ⅲ）,Hoehn-Yahr scale,SchabEngland scale,Mini-mental state examination（MMSE）scale were used to evaluate all the PD patients.Interleukin 6（IL-6）,interleukin 1β（IL-1β）,tumor necrosis factorα（TNF-α）and C-reactive protein（CRP）were detected by ELISA.Logistic regression model was used to analyze association between the inflammatory factors and PD with depression.Results About 42.5% PD patients had comorbid depression（48/113）.Age,gender,UPDRS-Ⅲ,Hoehn-Yahr scale and SchabEngland scale were not significantly different between the depression group and the non-depression group（P〈0.05）.Meanwhile,education level was significantly lower（P〈0.05）,disease course was significantly longer（P〈0.01）,MMSE score was significantly lower（P〈0.05）in the depression group than in the non-depression group.The levels of serum IL-6,IL-1β,TNF-αand CRP in all the PD patients（including depression and non-depression group）were predominantly higher than those in the normal control（all P〈0.01）.Compared to the non-depression group,all inflammatory factors were significantly higher in the mild,moderate,and severe depression groups（IL-6：F=6.52,P〈0.05;IL-1β：F=35.58,P〈0.01;TNF-α：F=42.27,P〈0.01;CRP：F=5.47,P〈0.05）.Moreover,the rise of the levels of the inflammatory factors was in keeping with the severity of the depression（P〈0.05）.Logistic regression revealed that the aging,long disease duration,low educationlevel,and the rise of the inflammatory factors levels were independent risk factors of depression（P〈0.05）.Conclusion The levels of inflammatory factors rose significantly in

关 键 词：帕金森病 抑郁症 炎性因子 

分 类 号：R742.5[医药卫生—神经病学与精神病学]