重度抑郁症患者血清sOB-R和Tenascin-C水平与生活事件和自杀意念的关系研究  

Study on the association between serum sOB-R,tenascin-C and life events,suicidal ideation in patients with severe depression

作　　者：冯雅琪 高依云 高培玲 FENG Yaqi;GAO Yiyun;GAO Peiling(Mental Health Center,The Second People's Hospital of Gansu Province,Lanzhou 730000,China;Psychiatric Department,Wuwei Anding Hospital,Wuwei 733099,Gansu,China)

机构地区：[1]甘肃省第二人民医院精神卫生中心,甘肃兰州730000 [2]武威安定医院精神科,甘肃武威733099

出　　处：《西部医学》2024年第12期1838-1843,共6页Medical Journal of West China

基　　金：甘肃省卫生行业科研计划项目(GSWSKY-2019-39)。

摘　　要：目的 探讨重度抑郁症患者血清可溶性瘦素受体(sOB-R)、肌腱蛋白C(Tenascin-C)与生活事件和自杀意念的关系。方法 根据有无自杀意念将甘肃省第二人民医院2020年1月—2021年12月收治的83例重度抑郁症患者(病例组)分为自杀意念组(n=37)和无自杀意念组(n=46),选取同期60例健康体检者为对照组。采用酶联免疫吸附法检测血清sOB-R、Tenascin-C水平,生活事件量表(LES)进行各组评分。采用Pearson积矩相关分析血清sOB-R、Tenascin-C与生活事件评分的关系,多因素Logistic回归分析其与自杀意念的关系,绘制受试者工作特征(ROC)曲线评估其对自杀意念的预测价值。结果 与对照组比较,病例组血清sOB-R降低,血清Tenascin-C升高,负性事件刺激量和生活事件应激总分升高,正性事件刺激量降低(P<0.05)。Pearson积矩相关分析结果显示,重症抑郁症患者血清sOB-R与负性事件刺激量呈负相关性(r=-0.649,P<0.05),Tenascin-C与负性事件刺激量呈正相关性(r=0.721,P<0.05)。多因素Logistic回归结果显示,女性、有自杀未遂史、合并焦虑、Tenascin-C升高、负性事件刺激量增加是自杀意念的独立危险因素(OR=1.384、1.338、1.481、1.372、 1.215,P<0.05),sOB-R升高是自杀意念的保护因素(OR=0.716,P<0.05)。sOB-R、Tenascin-C对自杀意念均有一定预测价值,AUC分别为0.805、0.816,联合预测的AUC为0.902,灵敏度、特异性分别为0.923、0.867。联合预测价值更高(Z=4.018、3.692,P<0.05)。结论 重度抑郁症患者血清sOB-R降低、Tenascin-C水平升高,两指标与生活事件评分密切相关且可有效预测自杀意念发生风险。Objective To explore the association between serum soluble leptin receptor(sOB-R),Tenascin-C and life events,suicidal ideation in patients with severe depression.Methods A total of 83 patients(case group)with severe depression admitted to our hospital were divided into suicidal ideation group(n=37)and non-suicidal ideation group(n=46)according to presence or absence of suicidal ideation.60 healthy volunteers who underwent physical examination during the same period were selected as control group.Serum sOB-R and tenascin-C levels were measured using enzyme-linked immunosorbent assay,and life events scale(LES)was used to assess the scores of each group.Pearson product moment correlation analysis was used to analyze the association between serum sOB-R,tenascin-C and life event scores.Multivariate logistic regression analysis was used to analyze the influence of serum sOB-R,tenascin-C on suicidal ideation.The receptor operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum sOB-R,tenascin-C for suicidal ideation.Results Serum sOB-R level in case group was lower than that in control group,while serum tenascin-C level was higher than that in control group(P<0.05).The amount of negative event stimulation and total score of life event stress were higher than those in control,while the amount of positive events stimulation was lower than that of control group(P<0.05).The Pearson product moment correlation analysis results showed that serum sOB-R was negative association with the amount of negative event stimulation in patients with severe depression(r=0.649,P<0.05),and tenascin-C was positively associated with the amount of negative event stimulation(r=0.721,P<0.05).The results of multivariate logistic regression showed that woman,a history of attempted suicide,anxiety,elevated tenascin-C,and an increase in amount of negative event stimulation were independent risk factors for suicidal ideation(OR=1.384,1.338,1.481,1.372,1.215;P<0.05),sOB-R was a protective factor for suicidal ideation(OR=0.7

关 键 词：重度抑郁症 可溶性瘦素受体 肌腱蛋白C 生活事件 自杀意念 

分 类 号：R749.4[医药卫生—神经病学与精神病学]