血清IL-6水平在首发抑郁症患者中检测价值研究

目的探讨血清细胞因子白细胞介素(IL)-6水平在首发抑郁症中的检测价值。方法 67例首发抑郁症患者(DP组)按如下分组:(1)用汉密尔顿抑郁量表(HAMD)评定患者抑郁程度,并根据量表总分按轻度抑郁(7≤HAMD17,n=15)、中度抑郁(17≤HAMD24,n=16)、重度抑郁(HAMD≥24,n=36)分为3组。(2)根据病程分半年以内(n=20)、半年至2年(n=16)、2年以上(n=22)3组;(3)根据不同性别分男(n=25)、女(n=42)2组;(4)根据不同年龄段50岁及以上(n=23)、40~49岁(n=20)、30~39岁(n=11)、29岁及以下(n=13)分4组;(5)检测患者甲状腺激素水平(n=56)。IL-6、甲状腺激素水平检测用电化学发光免疫法。28例健康者作对照组(NC组)。IL-6水平、甲状腺激素水平、HAMD因子分间进行Spearman相关分析,采用受试者工作特征(ROC)曲线下面积(AUC)评价IL-6在首发抑郁症中的诊断价值。结果 IL-6水平,DP组男、女均高于NC组男、女(P0.05);DP组各年龄段均高于NC组(P0.05);50岁以上组高于40~49岁组(P0.05),与30~39岁组、29岁以下组间差异无统计学意义(P0.05);40~49岁组、30~39岁组、29岁及以下组间差异无统计学意义(P0.05);不同HAMD总分和不同病程组均高于NC组(P0.05);轻度抑郁组高于重度抑郁组(P0.05),轻度抑郁组与中度抑郁组、中度抑郁组与重度抑郁组间比较差异无统计学意义(P0.05);病程半年以内、半年至2年、2年以上组组间差异无统计学意义(P0.05)。甲状腺激素水平,DP组和与NC组比较差异无统计学意义(P0.05)。IL-6水平与躯体性焦虑呈正相关关系(P0.05);FT4与工作和兴趣、激越呈负相关关系(P0.05);T3与疑病呈正相关关系(P0.05);T4与激越呈负相关关系(P0.05);IL-6与甲状腺激素均无相关性(P0.05)。IL-6水平在抑郁男、女组的AUC面积分别为0.434、0.815;在50岁以上组、40~49岁组、30~39岁组、29岁及以下组的AUC面积分别为0.705、0.769、0.826、0.776;在轻度抑郁组、中度抑郁组及重度抑郁组的AUC面积分别为0.620、0.840、0.693;在半年以内组、半年至2年组、2年以上组的AUC面积分别为0.448、0.876、0.810。结论细胞因子IL-6可能参与抑郁的发生发展,证明血清IL-6水平在抑郁女患者、各年龄段者、中及重度抑郁者、半年以上病程者有一定诊断价值,而在抑郁男患者、轻度抑郁者、半年以内病程者无诊断价值。

A study on the detection value serum level of IL-6 in patients with first episode depression

Objective To explore the detection value of serum interleukin 6(IL‐6) levels in patients with first episode depres‐sion .Methods A total of 67 patients with first episode depression(DP groups) were divided into different groups according to the following principals :(1)Hamilton depression rating scale(HAMD) was used to assess the degree of depression ,and according to the scale scores ,patients were classified as mild depression group(HAMD score was higher than 7 but lower than 17 ,n= 5) ,medi‐um depression group(HAMD score was higher than 17 but lower than 24 ,n= 16) and severe depression group(HAMD score was higher than 24 ,n= 36) ;(2)according to the course of disease ,20 patients were within 6 months ,and 16 patients were within 6 months to 2 years ,and 22 patients′ course of disease were over 2 years ;(3)there were 25 male patients and 42 female patients ;(4) according to different age groups ,patients were divided into over 50 years old(n= 23) ,40 - 49 years old(n= 20) and 30 - 39 years old(n= 11)nand under the age of 29(n= 13) ;(5)the thyroid hormone levels were detected in 56 patients .The level of IL‐6 ,thyroid hormone levels were detected by chemiluminescence immunoassay ,28 healthy people were chosen as control group(NC groups) .Re‐lationship between HAMD scores ,IL‐6 levels and thyroid hormone levels were analyzed by spearman correlation ,moreover ,area un‐der curve(AUC) was used to evaluate diagnostic value of IL‐6 for patients with first episode depression .Results The level of IL‐6 in DP group was significantly higher than that of NC group(P< 0 .05) .The levels of IL‐6 in all age groups of DP group were signif‐icantly higher than that of NC group(P< 0 .05) and which in over 50 years old group was significantly higher than that in 40 - 49 years old group(P< 0 .05) .While the differences of IL‐6 between the group of over 50 years old ,30 - 39 years old group and under the 29 years old group didn′t have statistical significance(P > 0 .05) .There was no statistical significance of IL‐6 between 40 - 49years old group ,30 - 39 years old group and under the 29 years old(P> 0 .05) .HAMD scores in mild group was significantly higher than that of the severe group(P < 0 .05) .There was no statistical difference of HAMD scores between mild group and moderate group(P> 0 .05)as well as between moderate group and severe group(P> 0 .05) .There was also no statistical difference between within six months ,six months to 2 years and over 2 years(P> 0 .05) .There were no statistical difference of thyroid hormone levels between DP group and NC group(P> 0 .05) .Body anxiety was positively correlated with IL‐6 levels(P < 0 .05) .FT4 levels were positively correlated with work and interests(P < 0 .05) .T3 levels had a positive correlation with hypochondriasis(P< 0 .05) .T4 levels were negatively correlated with agitation(P< 0 .05) .There was no correlation between IL‐6 and thyroid hormone(P> 0 .05) . AUC of IL‐6 levels in male and female were 0 .434 and 0 .815 respectively .The over 50 years old group ,40 - 49 years old group ,30- 39 years old group and under the 29 years old group of AUC area were 0 .705 ,0 .769 ,0 .826 and 0 .776 ,respectively .AUC of mild ,moderate and severe group were 0 .620 ,0 .840 and 0 .693 ,respectively .AUC of group within six months ,six months to 2 years ,over 2 years were 0 .448 ,0 .876 and 0 .810 ,respectively .Conclusion IL‐6 may participate in the development of depression , which proves that the serum level of IL‐6 in female patients with depression ,all age group patients ,moderate and severe depression and course of disease over six months have certain diagnostic value .While there were no diagnostic value for the male patients with depression ,mild depression ,the course of disease within half a year in the patients with first‐episode depression .