【摘要】 目的:探讨伴失眠的抑郁症患者认知功能特点及其血清炎性细胞因子水平变化。方法:根据《国际疾病分类》第10版诊断标准,85例抑郁症患者分为抑郁失眠组(44例)和抑郁非失眠组(41例);并进行匹兹堡睡眠质量指数(PSQI)及认知功能评估;采用酶免疫法测定血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果与37名正常对照者(正常对照组)比较。结果:①抑郁失眠组数字广度分、威斯康星卡片分类测验(WCST)分类数明显低于正常对照组,持续错误数明显高于正常对照组(P均<0. 01);抑郁非失眠组的数字广度分明显低于正常对照组(P <0. 01);抑郁失眠组WCST正确数、分类数明显低于抑郁非失眠组,WCST错误总数、持续错误数明显高于抑郁非失眠组(P均<0. 01)。②各组间的血清IL-6及TNF-α水平差异无统计学意义(F=1. 39、0. 65; P均> 0. 05)。③PSQI评分是抑郁症患者WCST各指标的主要影响因素(标准化β=-0. 29～0. 28; P <0. 05或P <0. 01)。结论:伴失眠的抑郁症患者执行功能损害明显,睡眠质量可能是抑郁症执行功能损害的主要影响因素。更多还原

【Abstract】 Objective: To explore the characteristics of cognitive function and the change of serum level of inflammatory cytokines in depression insomnia patients. Method: According to diagnostic criteria of International Classification of Diseases 10 th Edition( ICD-10),85 depression patients were divided into depression with insomnia group( 44 cases) and depression without insomnia group( 41 cases). Pittsburgh sleep quality index( PSQI) and cognitive functions were assessed. Serum levels of interleukin-6( IL-6) and tumor necrosis factor-α( TNF-α) were measured by enzyme immunoassays. These results in patients were compared with 37 normal controls( normal control group). Results: ① The scores of digit span and Wisconsin card sorting test( WCST) categories achievement in depression with insomnia group were significantly lower than those in normal control group( all P < 0. 01). WCST preservative errors in depression within somnia group was significantly higher than that in normal control group( P < 0. 01). The score of digit span in depression without insomnia group was significantly lower than that innormal control group( P < 0. 01). WCST corrects and WCST categories achievement in depression with insomnia group were significantly lower than those in depression without insomnia group( all P < 0. 01). WCST total errors and WCST preservative errors in depression with insomnia group were significantly higher than those in depression without insomnia group( all P < 0. 01) . ②No significant differences were observed in serum level of IL-6 and TNF-α among the three groups( F = 1. 39 and 0. 65,all P > 0. 05) . ③The score of PSQI was a mainin fluential factor for WCST performances in depression patients( standardized β =-0. 29-0. 28,P < 0. 05 or P < 0. 01). Conclusion: Depression patients with insomnia have obvious executive function deficit. Sleep quality may be the main influential factor for executive function deficit in depression patients.更多还原