细胞因子水平与无抽搐电休克治疗重度抑郁症疗效的相关性研究  

Effect of serum cytokine levels on the efficacy of modified electroconvulsive therapy for major depressive disorder

作　　者：乔云栓 刘海燕 李丽 牛杏珍 许艳艳 宗兴燕 李佩佩 高兴 卢薇 QIAO Yunshuan;LIU Haiyan;LI Li(Department of Psychiatry,Hengshui Seventh People’s Hospital,Hebei,Hengshui 053800,China)

机构地区：[1]河北省衡水市第七人民医院精神科,053800

出　　处：《河北医药》2024年第21期3288-3291,3295,共5页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20221496)。

摘　　要：目的探讨无抽搐电休克治疗(MECT)重度抑郁过程中血清细胞因子的变化与其疗效的相关性。方法选取2021年10月至2022年9月收治的重症抑郁症患者100例,于MECT治疗前、治疗后1周、2周、4周测定血清白介素1β(IL-1β)、IL-2、IL-6、IL-8、肿瘤坏死Cn因子-α(TNF-α)水平,同时采用汉密尔顿抑郁量表(HAMD)评估患者病情治疗效果,根据HAMD减分率分为有效组(n=68)和无效组(n=22)。结果有效组血清IL-1β在治疗1、2、4周后明显降低(P<0.05),血清IL-2水平在治疗1、2周后无明显下降,而在4周后明显降低(P<0.05);无效组IL-1β、IL-2水平治疗后均未见明显下降(P>0.05)。2组血清IL-6、TNF-α水平在治疗1、2周后均上升,且有效组上升幅度均大于无效组(P<0.05),而在4周后2组IL-6、TNF-α水平明显下降,且有效组下降的幅度大于无效组(P<0.05)。有效组在治疗1周后、2周后、4周后血清IL-8水平均明显上升(P<0.05),无效组治疗1周后、2周后、4周后血清IL-8水平均上升,且上升幅度均小于有效组,差异有统计学意义(P<0.05),而在治疗4周后较2周后血清IL-8水平无明显变化(P>0.05)。结论MECT治疗早期血清IL-1β水平明显下降,随着MECT治疗增加,血清IL-2、IL-6、TNF-α水平均明显下降,因此可通过早期测定血清IL-1β水平来预测MECT的疗效;血清IL-8水平上升的幅度越快,其MECT的疗效越好。Objective To observe the changes in serum levels of cytokines during the modified electroconvulsive therapy(MECT)for major depressive disorder(MDD)and their correlation with the efficacy.Methods A total of 100 MDD patients from October 2021 to September 2022 were included in our study.Before and 1,2 and 4 weeks after MECT,serum interleukin 1β(IL-1β),IL-2,IL-6、IL-8、and TNF-αwere measured.Disease condition was assessed by the Hamilton Depression Rating Scale(HAMD).evaluate the treatment effect.According to the HAMD reduction rate,MDD patients were divided into effective group and ineffective group.Results In the effective group,serum IL-1βsignificantly decreased at 1,2 and 4 weeks of MECT(P<0.05),while serum IL-2 did not significantly decrease at 1 and 2 weeks(P>0.05),but significantly decreased at 4 weeks(P<0.05).In the ineffective group,serum IL-1βand IL-2 did not significantly decrease(P>0.05).Serum IL-6 significantly increased at 1 and 2 weeks of MECT in both groups,which was more pronounced in the effective group than the ineffective group(P<0.05).Serum IL-6 was significantly reduced at 4 weeks in both groups,and more pronounced in the effective group than the ineffective group(P<0.05).Serum IL-8 significantly increased at 1,2 and 4 weeks of MECT in both groups,which was more pronounced in the effective group than the ineffective group(P<0.05).In the ineffective group,no significant difference in serum IL-8 was detected between 2 weeks and 4 weeks(P<0.05).Conclusion Serum IL-1βsignificantly decreases in the early stage of MECT,whereas serum IL-2 and IL-6 significantly decrease with the prolongation of MECT.An early measurement of serum IL-1βis able to predict the efficacy of MECT.A higher increase rate of IL-8 predicts a better efficacy of MECT on MDD patients.

关 键 词：无抽搐电休克 重症抑郁症 白介素-1Β 白介素-2 白介素-6 

分 类 号：R749.42[医药卫生—神经病学与精神病学]