T2DM患者颅内血管狭窄程度与抑郁症发生的关系及对相关血清细胞因子的影响  

Relationship between Intracranial Vascular Stenosis and Depression in T2DM Patients and Its Effect on Related Serum Cytokines

作　　者：郭宁宁[1] 孙青风 王霖霞[1] 高芳[1] 王光亚[1] 赵乃蕊[1] GUO Ning-ning;SUN Qing-feng;WANG Lin-xia;Gao fang;WANG Guang-ya;ZHAO Nai-rui(the Second Department of Endocrinology and Diabetes Mellitus, Cangzhou Central Hospital, Cangzhou, Hebei 061001, China;Department of Urology, People's Hospital of Cangzhou, Cangzhou, Hebei 061001, China)

机构地区：[1]沧州市中心医院内分泌糖尿病二科,河北沧州061001 [2]沧州市人民医院泌尿外科,河北沧州061001

出　　处：《临床误诊误治》2019年第4期69-73,共5页Clinical Misdiagnosis & Mistherapy

基　　金：沧州市重点研发计划指导项目(172302081)

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus, T2DM)患者颅内血管狭窄程度与抑郁症发生的关系,以及T2DM合并抑郁症患者相关血清因子变化。方法选取2016年2月—2018年1月在我院接受治疗的265例伴有不同程度颅内血管狭窄的T2DM患者,根据Samuels制定的颅内血管狭窄程度划分标准分为轻度狭窄组(A组)136例、中度狭窄组(B组)73例和重度狭窄组(C组)56例。观察A、B、C组抑郁症发病率;根据是否发生抑郁症将265例分为抑郁症组和非抑郁症组,观察每组患者同型半胱氨酸(Hcy)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、脑源性神经营养因子(BDNF)变化;进一步观察不同颅内血管狭窄程度的抑郁症患者(轻度狭窄亚组、中度狭窄亚组、重度狭窄亚组)Hcy、hs-CRP、IL-6、TNF-α、BDNF变化情况。结果 3组抑郁症发生率比较差异有统计学意义(P<0.05);随着颅内血管狭窄程度的加重,抑郁症患病率逐渐升高(P<0.05或P<0.01)。抑郁症组患者血清IL-6、TNF-α、Hcy、hs-CRP水平显著高于非抑郁症组患者,BDNF水平低于非抑郁症组患者,差异均有统计学意义(P<0.05或P<0.01)。轻度狭窄亚组、中度狭窄亚组和重度狭窄亚组患者血清IL-6、TNF-α、Hcy、hs-CRP及BDNF水平比较差异均有统计学意义(P<0.05或P<0.01);且随着颅内血管狭窄程度的加重,T2DM合并抑郁症患者血清IL-6、TNF-α、Hcy、hs-CRP水平均呈升高趋势,BDNF水平呈下降趋势,差异均有统计学意义(P<0.05或P<0.01)。结论 T2DM患者颅内血管狭窄程度与抑郁症的发生存在密切联系,血管狭窄程度越重者越易患有抑郁症;合并抑郁症者血清IL-6、TNF-α、Hcy、hs-CRP水平升高,BDNF水平降低,且随血管狭窄程度的加重,血清IL-6、TNF-α、Hcy、hs-CRP升高及BDNF下降越明显。Objective To investigate the relationship between the degree of intracranial vascular stenosis and depression in patients with type 2 diabetes melitus (T2DM) and to explore changes in serum cytokines in patients with T2DM combined with depression. Methods A total of 265 T2DM patients treated in our hospital from February 2016 to January 2018 for varying degrees of intracranial vascular stenosis were enrolled in the study. According to the criteria for the classification of intracranial vascular stenosis set by Samuels, patients were divided into mild stenosis group (group A, n =136), moderate stenosis group (group B, n =73) and severe stenosis group (group C, n =56). The incidence of depression in each group was observed. According to the presence or absence of depression, 265 patients were divided into depression group and non-depression group. Changes in homocysteine (Hcy), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), and brain-derived neurotrophic factor (BDNF) in each group were observed. The changes of Hcy, hs-CRP, IL-6, TNF-α, and BDNF were further observed in depression patients with different degrees of vascular stenosis (mild stenosis subgroup, moderate stenosis subgroup, and severe stenosis subgroup). Results The incidence of depression in the three groups was statistically significant ( P <0.05);With the aggravation of intracranial vascular stenosis, the prevalence of depression was gradually increased ( P <0.05 or P <0.01). The levels of serum IL-6, TNF-α, Hcy, and hs-CRP were significantly higher in depression group than in non-depression group, and the levels of BDNF were lower than those in non-depression group. The differences were statistically significant ( P <0.05 or P <0.01). The levels of serum IL-6, TNF-α, Hcy, hs-CRP and BDNF were statistically significant in mild stenosis subgroup, moderate stenosis subgroup and severe stenosis subgroup ( P <0.05 or P <0.01). With the aggravation of intracranial vascular stenosis, serum IL-6, TNF-α

关 键 词：糖尿病 2型 血管狭窄 抑郁症 细胞因子 

分 类 号：R587.1[医药卫生—内分泌]