【摘要】 目的探讨血清炎症细胞因子水平与抗抑郁疗效的关系。方法对91例抑郁症患者进行选择性5-羟色胺再摄取抑制剂(SSRI)单药治疗4周,采用汉密尔顿抑郁量表(HAMD-17)评估抗抑郁疗效,ELISA法检测治疗前后血清IL-6、TNF-α水平,并分析其与HAMD-17评分的关系。结果抗抑郁治疗4周时,显效70例,非显效(好转+无效)21例。显效组与非显效组治疗前血清IL-6、TNF-α水平及HAMD-17评分比较,差异均无统计学意义(均P>0.05);治疗后显效组上述指标均低于非显效组(均P<0.05)。显效组血清IL-6减分率、TNF-α减分率与HAMD-17减分率均呈正相关(r=0.461、0.397,均P<0.05);非显效组血清IL-6减分率、TNF-α减分率与HAMD-17减分率均无关(均P>0.05)。血清TNF-α减分率对HAMD-17减分率有正向预测作用。结论抑郁症患者经SSRI类药物治疗4周,其血清炎症细胞因子水平及HAMD-17评分均明显下降,且血清炎症细胞因子水平与抑郁症状的改善有关;血清TNF-α水平的有效降低预示抗抑郁疗效较好。更多还原

【Abstract】 Objective To investigate the relationship between serum inflammatory cytokine levels and antidepressant efficacy. Methods Ninety one patients with depression were treated with selective 5-serotonin reuptake inhibitor(SSRI) for 4 wks. The efficacy of antidepressant was evaluated by Hamilton Depression Scale(HAMD-17), the level of serum IL-6 and TNF-αbefore and after treatment was detected by ELISA. The relationship between serum inflammatory cytokine levels and HAMD-17 score was analyzed. Results At 4 wks of antidepressant treatment, 70 cases were apparently effective, and 21 cases were not apparently effective(improvement + invalid). There were no significant differences in serum IL-6, TNF-α levels before treatment between apparently effective group and non-apparently effective group(all P >0.05), and the above indexes were significantly lower in the apparently effective group after treatment than those in non-apparently effective group(all P<0.05). The serum IL-6 reduction rate, TNF-α reduction rate and HAMD-17 reduction rate were positively correlated in the apparently effective group(r=0.461, 0.397, P<0.05), and the serum IL-6 reduction rate and TNF-α reduction rate of non-apparently effective group were not correlated with the HAMD-17 reduction rate(all P >0.05). Serum TNF-α reduction rate had a positive predictive effect on HAMD-17 reduction rate. Conclusion The serum inflammatory cytokine levels after treatment are associated with the efficacy of SSRI therapy in patients with depression.更多还原