抑郁症晨重夕轻特征与生物学的关系

目的:探讨抑郁症患者临床症状晨重夕轻的特征与血浆皮质醇、细胞因子浓度的关系。方法:采用放射免疫法、酶联免疫吸附法对55例双相障碍(抑郁相)和抑郁发作诊断标准的抑郁症患者及38名正常对照组早7:00、晚7:00血浆皮质醇、IL-6、IL-2浓度进行测定,比较各指标早、晚浓度及早晚差值在抑郁症晨重夕轻组和无晨重夕轻组以及正常对照组的差异。结果:抑郁症晨重夕轻组和无晨重夕轻组早间的皮质醇浓度、早晚之间的皮质醇浓度差值均较正常对照组显著增高;晨重夕轻组晚间的血IL-6浓度较正常对照组显著增高,两组的IL-6早晚的差值与正常对照组相比有显著性差异;晨重夕轻组和无晨重夕轻组晚间IL-2水平均明显低于正常对照组。结论:抑郁症患者不管临床症状有无晨重夕轻的特征,均存在血浆皮质醇浓度早晨高于晚上和血浆IL-6浓度晚上高于早晨的异常改变。

Relationship between the characteristics of diurnal rhythm and biology in paitents with depressive disorders

Objective:To study the relationship between characteristics of diurnal rhythm and the plasma level of cytokine and cortisol in patients with depressive disorders. Method:55 depressed patients met diagnostic criteria and 38 healthy normal controls were studied,the levels of cortisol,IL-6 and IL-2 at 7am and 7pm were measured by radioimmunoassay and enzyme-linked immunosorbent assays,each indexes morning-evening levels and differences were compared among the depressed group with diurnal variation(mood worsening in the morning),the depressed group without diurnal variation and healthy normal controls. Results:There were significantly increased of the cortisol level and the morning-evening difference in the depressed group with and without diurnal variation compared with the healthy normal controls.IL-6 evening level of the depressed group with diurnal variation was significantly increased compared with healthy controls,IL-6 morning-evening difference of two groups vary obviously compared with normal controls.IL-2 evening level of two groups was obviously lower than that of normal controls. Conclusion:No matter there are clinical symptoms of the characteristics of diurnal rhythm variation or not,all depressed patients have been shown the abnormal variations,which are the higher cortisol levels in the morning than those in the evening and the higher IL-6 levels in the evening than those in the morning.