抑郁症患者外周血辅助性T细胞与抗抑郁药疗效的相关性研究  

Correlation analysis between peripheral blood helper T cells and antidepressant efficacy in patients with depression

作　　者：李光[1] 张玲 刘敏 贺毅 孙作厘 Li Guang;Zhang Ling;Liu Min;He Yi;Sun Zuoli(Department of Gastroenterology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Beijing Key Laboratory of Mental Disorders,the National Clinical Research Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京朝阳医院消化内科,100020 [2]首都医科大学附属北京安定医院国家精神心理疾病临床医学研究中心精神疾病诊断与治疗北京市重点实验室,100088

出　　处：《神经疾病与精神卫生》2022年第7期468-473,共6页Journal of Neuroscience and Mental Health

基　　金：国家自然科学基金项目(82171525)。

摘　　要：目的探讨抑郁症患者辅助T淋巴细胞(Th)1与Th2亚型的变化及其与抗抑郁药治疗效果的相关性。方法纳入2020年10月至2021年12月在首都医科大学附属北京安定医院就诊的37例抑郁症患者作为抑郁症组,选取年龄、性别等相匹配的39名健康者作为健康对照组。采用17项汉密尔顿抑郁量表(HAMD-17)评估患者的疾病严重程度,并计算治疗前后HAMD-17的减分率,减分率≥50%为治疗应答,<50%为治疗无应答。通过流式细胞术检测所有受试者外周血Th1和Th2细胞比例,比较治疗前抑郁症组和健康对照组Th细胞比例差异。对抑郁症患者进行为期8~12周的抗抑郁治疗,比较治疗前后治疗应答组和治疗无应答组患者的Th细胞比例差异。采用Spearman相关分析患者Th细胞亚群比例与HAMD-17评分的相关性。结果抑郁症组治疗前Th1细胞比例为(43.61±24.27)%,高于健康对照组的(26.13±18.56)%,差异有统计学意义(t=-3.538,P<0.01)。抗抑郁治疗后,抑郁症组患者HAMD-17总分为(10.73±7.02)分,低于治疗前的(20.68±4.24)分,差异有统计学意义(t=8.566,P<0.01)。共31例患者于治疗后完成Th细胞的检测,将患者分为治疗无应答组(13例)和治疗应答组(18例),重复测量方差分析显示,组别和时间的交互作用对Th1细胞比例的影响差异有统计学意义(F=7.306,P=0.011);治疗无应答组治疗前的Th1细胞比例高于治疗应答组[(7.19±1.62)%比(5.31±2.38)%],且治疗后低于治疗前[(4.29±2.10)%比(7.19±1.62)%],差异均有统计学意义(均P<0.01)。相关性分析显示,抑郁症患者治疗前后HAMD-17减分率与治疗前Th1细胞比例呈负相关(r=-0.429,P=0.008),与治疗前后Th2/Th1细胞比值呈负相关(r=-0.357,P=0.048),与治疗前后Th1细胞比例呈正相关(r=0.591,P<0.001)。结论抑郁症患者外周血Th1细胞比例检测有助于抗抑郁药治疗效果的早期预测。Objective To explore the changes of helper T lymphocytes(Th)1 and Th2 subtypes in patients with depression and their relationships with the efficacy of antidepressant treatment.Methods A total of 37 patients with depression treated in Beijing Anding Hospital affiliated to Capital Medical University from October 2020 to December 2021 were selected as depression group.Another 39 healthy individuals whose age and gender matched were enrolled as the control group.The 17-item Hamilton Depression Rating Scale(HAMD-17)was used to evaluate the disease severity of the patients.The reduction rate of HAMD-17 score before and after treatment was calculated.It was treatment response if the score reduction rate is equal or higher than 50%,otherwise it was treatment non-response.The proportion of Th1 and Th2 cells in peripheral blood of all subjects was detected by flow cytometry,and the differences of Th1 and Th2 cell ratio between depression group and control group was compared before treatment.Patients with depression were treated with antidepressants for 8-12 weeks.The proportion of Th cells in the treatment response group and the treatment non-response group were compared before and after treatment.Spearman correlation analysis was used to analyze the correlation between the proportion of Th cell subsets and HAMD-17 score.Results The proportion of Th1 cells in depression group was(43.61±24.27)%before treatment,which was higher than that in control group(26.13±18.56)%.The difference was statistically significant(t=-3.538,P<0.01).After antidepressant treatment,the total score of HAMD-17 in the depression group was(10.73±7.02),lower than that before treatment(20.68±4.24),and the difference was statistically significant(t=8.566,P<0.01).A total of 31 patients completed the detection of Th cells after treatment.The patients were divided into treatment non-response group(13 cases)and treatment response group(18 cases).Repeated measurement analysis of variance showed that the interaction of group and time had a statistically s

关 键 词：抑郁症 辅助T淋巴细胞 疗效 

分 类 号：R749.4[医药卫生—神经病学与精神病学]