胆碱酯酶在抑郁症与双相情感障碍炎症免疫调节的临床价值  

Clinical value of cholinesterase in depression and bipolar disorder

作　　者：陆玲娜 胡希文 HU Xi-wen;LU Ling-na(Department of Psychiatry,Affiliated Mental Health Center and Hangzhou Seventh People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310013,China)

机构地区：[1]浙江省立同德医院检验科,310013 [2]浙江大学医学院附属精神卫生中心 [3]杭州市第七人民医院精神科

出　　处：《临床精神医学杂志》2024年第6期482-485,共4页Journal of Clinical Psychiatry

基　　金：浙江省医药卫生科技项目(2022KY124);浙江省基础公益研究计划项目(TGC23H090003);杭州市农业与社会发展科研引导项目20221231Y055。

摘　　要：目的:初步探讨胆碱酯酶(cholinesterase,CHE)在抑郁症与双相情感障碍(bipolar disorder,BD)炎症反应中的临床价值。方法:回顾性纳入2020年3月至2022年5月浙江省立同德医院住院的抑郁症74例(抑郁组),BD 30例(双相组),健康对照38名(对照组),检测所有受试者外周血CHE与超敏C反应蛋白(C-reactive protein,CRP)的水平,采用Pearson分析抑郁组、双相组中CHE与CRP的相关性,并采用受试者工作特征曲线(receiver operating characteristic,ROC)检验CHE的诊断效能。结果:抑郁组与双相组的CHE水平均高于对照组,而双相组CRP高于对照组(P均<0.05)。且双相组中CHE与CRP的正相关性(r=0.67,P<0.05)。CHE在抑郁症和BD中均有一定的诊断效能,在抑郁症中CHE的曲线下面积(area under the curve,AUC)为0.69,cutoff值为8302.50 U/L,敏感度0.65,特异性0.79,在BD中CHE的AUC为0.70,cutoff值为8419 U/L,敏感度0.57,特异性0.82。结论:胆碱能抗炎通路可能参与了抑郁症与BD免疫稳态的维持,CHE或许是一种具有潜力的生物学标志物。Objective:To preliminarily investigate the clinical value of cholinesterase(CHE)in the inflammatory responses associated with depression disorder and bipolar disorder(BD).Method:74 cases of depression(depression group),30 cases of BD(BD group)and 38 cases of healthy control(control group)hospitalized in Zhejiang Provincial Tongde Hospital from March 2020 to May 2022 were retrospectively included,and the levels of CHE and C-reactive protein(CRP)were tested in all subjects,and the correlation between CHE and CRP in the depression and bipolar groups was analyzed by Pearson's analysis.The diagnostic efficacy of CHE was examined by receiver operating characteristic(ROC)curve.Results:The CHE levels in both the depression and BD groups were significantly higher than those in the control group,while the CRP levels in the BD group were significantly higher than those in the control group(all P<0.05).And the positive correlation between CHE and CRP in the BD group(r=0.67,P<0.05).CHE had some diagnostic efficacy in both depression and BD.In depression,the area under the curve(AUC)of CHE was 0.69,the cutoff value was 8302.50 U/L,the sensitivity was 0.65,and the specificity was 0.79,and in BD,the CHE's AUC was 0.70,the cutoff value was 8419 U/L,the sensitivity was 0.57 and the specificity was 0.82.Conclusion:The cholinergic anti-inflammatory pathway may be involved in maintaining immune homeostasis in depression and BD,and CHE may serve as a potential biological marker.

关 键 词：抑郁症 双相情感障碍 胆碱酯酶 炎症 

分 类 号：R749.4[医药卫生—神经病学与精神病学]