类风湿关节炎患者氧化应激与抑郁情绪的关系

目的:探讨类风湿关节炎患者氧化应激状态与抑郁情绪之间的关系。方法:用Hamilton抑郁量表、Zung自测抑郁量表、Zung自测焦虑量表、SCL-90(symptom checklist 90)症状量表及多项目问卷对129名类风湿关节炎患者进行调查评估,20例正常人作为对照组,在进行治疗前检测血浆氧化应激指标。根据Hamilton抑郁量表将类风湿关节炎患者分为抑郁组(≥20分,A组)和非抑郁组(<20分,B组),正常人作为对照组(C组)。结果:研究发现类风湿关节炎患者抗氧化酶防御能力下降。A组SDS(self-rating depression scale)评分为(59.12±10.18)分,B组SDS评分为(39.24±5.02)分,两组间比较差异有统计学意义(t=0.42,P<0.01)。A组SAS(self-rating anxietyscale)评分为(52.85±6.35),B组SAS评分为(39.24±5.02)分,两组间比较差异有统计学意义(t=1.48,P<0.01)。A组患者抗超氧阴离子自由基(antisuperoxide anion capacity,A-ASC)水平(393.76±43.35)明显低于B组(456.98±93.86)及C组(483.51±30.64)(F=3.95,P=0.03);A组患者丙二醛(malondialdehyde,MDA)水平(13.84±3.35)明显高于B组(9.42±3.52)及C组(7.86±3.21)(F=12.01,P=0.01)。Pearson相关分析示MDA与抑郁呈明显正相关(r=0.58,P<0.05),A-ASC与抑郁呈明显负相关(r=-0.30,P<0.05)。结论:类风湿关节炎患者存在氧化损伤,伴抑郁症状的患者抗氧化酶防御能力进一步减弱,提示氧化应激可能与类风湿关节炎抑郁症状的发生和发展密切相关。

Relationship between oxidative stress and depression in patients with rheumatoid arthritis

Objective: To investigate the relationship between oxidative stress and depression in patients with rheumatoid arthritis(RA).Methods: In the study,129 patients with RA were assessed using the Hamilton depression rating scale(HAMD),Zung self-rating depression scale(SDS),Zung self-rating anxiety scale(SAS),symptom checklist 90(SCL-90),and other multipleitem questionnaires.Oxidative-stress-related parameters in sera and indexes of oxidative damage were monitored during a pretreatment period.The patients were divided into depression(group A,HAMD≥20) and nondepression groups(group B,HAMD<20) based on an HAMD score cutoff of 20.In addition,20 healthy donors were classified as group C.Results: A statistically significant increase in SDS score was observed in group A(59.12±10.18) when compared with group B(39.24±5.02)(t=0.42,P < 0.01).A statistically significant increase was observed in SAS score in group A(59.12±10.18) in comparison with group B(39.24±5.02)(t=1.48,P<0.01).Antisuperoxide anion capacity was significantly decreased in group A(393.76±43.35) in comparison with group B(456.98±93.86) and group C(483.51±30.64)(F=3.95,P=0.03),whereas serum malondialdehyde(MDA) levels of group A(13.84±3.35) were higher than those of group B(9.42±3.52) and group C(7.86±3.21)(F=12.01,P=0.01).Pearson correlation analysis revealed that depression was positively correlated with MDA(r=0.58,P<0.05),but negatively with A-ASC(r =-0.30,P<0.05).Conclusion: The oxidative damage occurs in patients with rheumatoid arthritis,and lower antioxidant defences exist in depressive patients.The oxidative stress may promote the development of depression.