糖尿病共病抑郁患者血清炎性反应与脑弥散张量成像特点分析  

The serum inflammatory reaction and diffusion tensor imaging characteristics in patients with diabetes mellitus complicated by depression

作　　者：王京贤 张春平 墨亚芳 赵静[3] 杜秀芳 WANG Jingxian;ZHANG Chunping;MO Yafang(Department of Mental Health,Shijiazhuang Hospital for Maternal and Child Health,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市妇幼保健院精神卫生科,050000 [2]河北省石家庄市妇幼保健院妇产科,050000 [3]河北省石家庄市第八医院精神卫生科

出　　处：《河北医药》2020年第1期106-108,112,共4页Hebei Medical Journal

摘　　要：目的探讨糖尿病共病抑郁与抑郁症患者血清炎性反应、神经内分泌指标与脑弥散张量成像特点的对照分析。方法选择2014年10月至2016年12月诊断糖尿病共病抑郁患者60例为研究组,同期抑郁症患者60例为对照组。采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑表(HAMA)进行临床症状评分。采用Elisa法检测血清白介素-10(IL-10)、转化生长因子-β(TGF-β)、白介素-6(IL-6)水平,免疫比浊法检测血清超敏-C反应蛋白(hs-CRP)水平变化,放射免疫法检测血清皮质醇(COR)、促肾上腺皮质激素(ACTH),利用磁共振弥散张量成像测量额上回、扣带回、海马、海马旁回、半卵圆中心区各向异性分数(FA)。结果研究组患者HAMD评分、COR、ACTH、HAMA评分高于对照组(P<0.05),研究组血清hs-CRP、IL-6水平升高,IL-10、TGF-β水平降低,2组比较差异有统计学意义(P<0.05)。研究组额上回、扣带回、海马、海马旁回、半卵圆中心区各向异性分数较对照组明显下降,2组比较差异有统计学意义(P<0.05)。结论与抑郁症比较,糖尿病共病抑郁患者临床症状更加严重,血清炎性反应程度与神经内分泌指标水平升高,磁共振功能成像显示患者存在明显多区脑白质微结构异常。Objective To investigate the serum inflammatory response,neuroendocrine indexes and brain diffusion tensor imaging(DTI)characteristics in patients with diabetes mellitus complicated by depression.Methods A total of 60 patients with diabetes mellitus complicated by depression who were treated in our hospital from October 2014 to December 2016 were enrolled as research group,at the same time,the other 60 patients with depression were enrolled as control group.The clinical symptom scores were performed by using Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA).The serum levels of interleukin-10(IL-10),transformation growth factorβ(TGF-β),interleukin-6(IL-6)were detected by ELISA,and the serum levels of hypersensitivity-C reactive protein(hs-CRP)were detected by immunoturbidimetric method.And the serum levels of cortisol(COR)and adrenocorticosteroid(ACTH)were detected by radioimmunoassay,moreover,the anisotropy scores(FA)were measured by magnetic resonance dispersion tensor imaging.Results The HAMD score,COR,ACTH and HAMA score in research group were significantly higher than those in control group(P<0.05).The serum levels of hs-CRP and IL-6 in research group were significantly increased,however,the serum levels of IL-10 and TGF-βin research group were significantly decreased,moreover,there were significant differences between the two groups(P<0.05).The anisotropy scores of the superior frontal gyrus,cingulate gyrus,hippocampus,parahippocampal gyrus and semioval center in research group were significantly lower than those in control group(P<0.05).Conclusion As compared with those in the patients with depression,the clinical symptoms in patients with diabetes mellitus complicated by depression are more severe,and the serum inflammatory reaction degree and neuroendocrine indexes are increased,and MRI functional imaging shows that the patients have significant multiregion alba microstructural abnormalities.

关 键 词：弥散张量成像 抑郁症 糖尿病 炎性反应 

分 类 号：R749.42[医药卫生—神经病学与精神病学]