老年抑郁症患者血清指标与认知功能的相关性研究

陈寿林; 朱生芝; 于畅; 谢曙光; 郑成应

doi:10.16766/j.cnki.issn.1674-4152.002375

老年抑郁症患者血清指标与认知功能的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.002375

1.
宁波市康宁医院检验科，浙江宁波 315201
2.
宁波市镇海区庄市街道社区卫生服务中心
3.
宁波市康宁医院精神障碍科二病区
4.
宁波市康宁医院心理测验室
5.
宁波市康宁医院老年病区

基金项目:

浙江省医药卫生科技计划项目 2019RC079

详细信息

通讯作者:
陈寿林，E-mail：749148835@qq.com

中图分类号: R749.16 R446
计量
- 文章访问数: 177
- HTML全文浏览量: 54
- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2021-03-12
- 网络出版日期: 2022-08-13

Correlation between serum indexes and cognitive function in elderly patients with depression

1.
Department of Laboratory Medicine, Ningbo Kangning Hospital, Ningbo, Zhejiang 315201, China

摘要

摘要: 目的探讨老年抑郁症患者血清指标与认知功能的相关性，为临床老年抑郁症诊断提供参考。方法选取2018年6月—2019年6月宁波市康宁医院收治的老年抑郁症患者50例设为抑郁组，另选取50例健康体检者设为对照组。比较2组的认知功能、抑郁程度及血清指标，采用Pearson法分析抑郁组血清指标与认知功能的相关性。结果抑郁组汉密尔顿抑郁量表(HAMD)评分为(25.44±4.68)分，明显高于对照组[(4.52±2.24)分，P < 0.05]，简易智能状态检查表(MMSE)评分为(22.36±2.83)分，明显低于对照组[(27.02±2.35)分，P < 0.05]，抑郁组HAMD评分与MMSE评分呈负相关关系(r=-0.420，P < 0.05)。抑郁组5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)水平明显低于对照组(均P < 0.05)，与HAMD评分呈负相关关系(r=-0.532、-0.477、-0.494，均P < 0.05)，与MMSE评分呈正相关关系(r=0.525、0.476、0.506，均P < 0.05)。抑郁组同型半胱氨酸(Hcy)、胱抑素-C(Cys-C)、白细胞介素(IL)-1β、IL-18水平明显高于对照组(均P < 0.05)，与HAMD评分呈正相关关系(r=0.444、0.457、0.575、0.540，均P < 0.05)，与MMSE评分呈负相关关系(r=-0.404、-0.372、-0.594、-0.419，均P < 0.05)。结论老年抑郁症患者血清指标水平与其抑郁程度、认知功能密切相关，随患者抑郁程度增加、认知水平下降，5-HT、DA、NE水平逐渐降低，Hcy、Cys-C、IL-1β、IL-18水平逐渐升高。
- 老年 /
- 抑郁症 /
- 神经递质 /
- 炎症指标 /
- 认知功能
Abstract: Objective To explore the correlation between serum index and cognitive function in elderly patients with depression and provide reference for clinical diagnosis of senile depression. Methods From June 2018 to June 2019, 50 elderly patients with depression in Ningbo Kangning Hospital were selected as the depression group, and 50 healthy people were selected as the control group. The cognitive function, depression degree and serum indexes were compared between the two groups. Pearson method was used to analyse the correlation between serum indicators and cognitive function in depression group. Results The Hamilton depression scale (HAMD) score of the depression group was (25.44±4.68) points, which was significantly higher than that of the control group [(4.52±2.24) points, P < 0.05], and the mini-mental state examination (MMSE) score was (22.36±2.83) points, which was significantly lower than that of the control group [(27.02±2.35) points, P < 0.05]. There was a negative correlation between HAMD score and MMSE score in the depression group (r=-0.420, P < 0.05). The levels of 5-hydroxytryptamine (5-HT), dopamine (DA) and norepinephrine (NE) in the depression group were significantly lower than those in the control group (all P < 0.05), were negatively correlated with HAMD score (r=-0.532, -0.477, -0.494, all P < 0.05) and positively correlated with MMSE score (r=0.525, 0.476, 0.506, all P < 0.05). The levels of homocysteine (Hcy), Cystatin-C (Cys-C), interleukin (IL)-1β and IL-18 were significantly higher than those in the control group (all P < 0.05), were positively correlated with HAMD score (r=0.444, 0.457, 0.575, 0.540, all P < 0.05) and negatively correlated with MMSE score (r=-0.404, -0.372, -0.594, -0.419, all P < 0.05). Conclusion The level of serum indexes in elderly patients with depression is closely related to the degree of depression and cognitive function. With the increase of depression degree and the decrease of cognitive level, the levels of 5-HT, DA and NE gradually decrease, whereas the levels of Hcy, Cys-C, IL-1β and IL-18 gradually increase.
- Elderly /
- Depression /
- Neurotransmitters /
- Indicators of inflammation /
- Cognitive function

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表 1 2组研究对象一般资料比较

Table 1. Comparison of general data of two groups of subjects

组别	例数	性别(例)		年龄 (x±s，岁)	受教育程度(例)
组别	例数	男性	女性	年龄 (x±s，岁)	小学以下	中学	中学以上
对照组	50	26	24	68.78±7.02	13	27	10
抑郁组	50	22	28	68.12±6.51	14	29	7
统计量		0.641^a		0.487^b	-0.582^c
P值		0.423		0.627	0.561
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组研究对象HAMD、MMSE评分比较(x±s，分)

Table 2. Comparison of HAMD and MMSE scores of two groups of subjects (x±s, score)

组别	例数	HAMD评分	MMSE评分
对照组	50	4.52±2.24	27.02±2.35
抑郁组	50	25.44±4.68	22.36±2.83
t值		-28.511	8.958
P值		< 0.001	< 0.001

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表 3 2组研究对象神经递质含量比较(x±s，ng/L)

Table 3. Comparison of neurotransmitter content between the two groups (x±s, ng/L)

组别	例数	5-HT	DA	NE
对照组	50	274.51±22.34	37.28±3.56	136.74±14.22
抑郁组	50	232.57±23.46	29.25±3.28	102.78±12.16
t值		9.154	11.730	12.834
P值		< 0.001	< 0.001	< 0.001

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表 4 2组研究对象Hcy、Cys-C水平比较(x±s)

Table 4. Comparison of Hcy and Cys-C levels between the two groups (x±s)

组别	例数	Hcy(μmol/L)	Cys-C(mg/L)
对照组	50	8.35±2.71	0.73±0.12
抑郁组	50	21.20±5.54	0.97±0.24
t值		-14.733	-6.325
P值		< 0.001	< 0.001

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表 5 2组研究对象炎症指标水平比较(x±s)

Table 5. Comparison of inflammatory indexes between the two groups (x±s)

组别	例数	IL-1β(ng/L)	IL-18(pg/mL)
对照组	50	29.74±5.93	148.67±30.17
抑郁组	50	48.37±5.80	195.73±49.89
t值		-15.881	-5.708
P值		< 0.001	< 0.001

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表 6 抑郁组相关性分析

Table 6. Correlation analysis of depression group

项目	HAMD评分		MMSE评分
项目	r值	P值	r值	P值
5-HT	-0.532	< 0.001	0.525	< 0.001
DA	-0.477	< 0.001	0.476	< 0.001
NE	-0.494	< 0.001	0.506	< 0.001
Hcy	0.444	< 0.001	-0.404	0.004
Cys-C	0.457	< 0.001	-0.372	0.008
IL-1β	0.575	< 0.001	-0.594	< 0.001
IL-18	0.540	< 0.001	-0.419	0.002

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参考文献(20)

[1]	ZHANG Y, CHEN Y, MA L. Depression and cardiovascular disease in elderly: Current understanding[J]. J Clin Neurosci, 2018, 47(9): 1-5.
[2]	杜远, 王龙, 张许来, 等. 运动对抑郁症症状、认知功能和γ-氨基丁酸影响的对照研究[J]. 中华全科医学, 2019, 17(9): 1547-1550. doi: 10.16766/j.cnki.issn.1674-4152.000994 DU Y, WANG L, ZHANG X L, et al. Exercise influence depression ' s symptom, cognitive function and GABA in control study[J]. Chinese Journal of General Practice, 2019, 17(9): 1547-1550. doi: 10.16766/j.cnki.issn.1674-4152.000994
[3]	SHI S, LI L, SONG L, et al. Effect of lamotrigine on cognitive function and serum inflammatory factors in patients with depression of recurrent bipolar disorder[J]. Pak J Pharm Sci, 2018, 31(6): 2775-2778.
[4]	TENG S, THOMSON P, MCCARTHY S, et al. Rare disruptive variants in the DISC1 interactome and regulome: Association with cognitive ability and schizophrenia[J]. Mol Psychiatry, 2018, 23(5): 1270-1277. doi: 10.1038/mp.2017.115
[5]	过伟峰, 曹晓岚, 盛蕾, 等. 抑郁症中西医结合诊疗专家共识[J]. 中国中西医结合杂志, 2020, 40(2): 141-148. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ202002006.htm GUO W F, CAO X L, SHENG L, et al. Expert consensus on Integrated Traditional Chinese and Western medicine diagnosis and treatment of depression[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2020, 40(2): 141-148. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ202002006.htm
[6]	潘向荣, 刘若兰, 李旭. 低频聚焦超声刺激联合盐酸帕罗西汀对老年人抑郁症患者疗效观察[J]. 湖北大学学报(自然科学版), 2020, 42(3): 316-319. https://www.cnki.com.cn/Article/CJFDTOTAL-HDZK202003014.htm PAN X R, LIU R L, LI X. Effect of low frequency focused ultrasound stimulation combined with paroxetine hydrochloride on elderly patients with depression[J]. Journal of Hubei University (Natural Science Edition), 2020, 42(3): 316-319. https://www.cnki.com.cn/Article/CJFDTOTAL-HDZK202003014.htm
[7]	钟古华, 廖君兰, 刘其贵. 阿戈美拉汀联合重复经颅磁刺激治疗老年难治性抑郁症患者疗效及其对认知功能的影响[J]. 精神医学杂志, 2018, 31(2): 122-125. https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201802012.htm ZHONG G H, LIAO J L, LIU Q G. Effect of agomelatine combined with repetitive transcranial magnetic stimulation on cognitive function in elderly patients with refractory depression[J]. Journal of Psychiatry, 2018, 31(2): 122-125. https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201802012.htm
[8]	陈昕, 赵鹤亮. 中国社区中老年人抑郁情绪与认知功能的相关性[J]. 中国老年学杂志, 2018, 38(4): 971-973. doi: 10.3969/j.issn.1005-9202.2018.04.083 CHEN X, ZHAO H L. Correlation between depression and cognitive function of middle-aged and elderly people in Chinese community[J]. Chinese Journal of Gerontology, 2018, 38(4): 971-973. doi: 10.3969/j.issn.1005-9202.2018.04.083
[9]	LEE S, KANG Y, CHO S. Subjective cognitive decline in patients with migraine and its relationship with depression, anxiety, and sleep quality[J]. J Headache Pain, 2017, 18(1): 77. doi: 10.1186/s10194-017-0779-1
[10]	BAILEY D, BRUGNIAUX J, FILIPPONI T, et al. Exaggerated systemic oxidative-nitrosative-inflammatory stress in chronic mountain sickness is associated with cognitive decline and depression[J]. J Physiol, 2018, 597(2): 611-629.
[11]	徐雪云, 李神赐. 艾司西酞普兰联合丙戊酸钠缓释剂治疗老年抑郁症的疗效[J]. 浙江临床医学, 2020, 22(9): 1308-1309. https://www.cnki.net/KCMS/detail/detail.aspx?dbcode=IPFD&filename=ZJKX201811008046&dbname=IPFDLAST2022 XU X Y, LI S C. Efficacy of escitalopram combined with sodium valproate sustained release in the treatment of senile depression[J]. Zhejiang Clinical Medicine, 2020, 22(9): 1308-1309. https://www.cnki.net/KCMS/detail/detail.aspx?dbcode=IPFD&filename=ZJKX201811008046&dbname=IPFDLAST2022
[12]	尹艳, 凌桂晨, 冯铁为, 等. 抑郁症与人体免疫炎症因子的研究进展[J]. 国际免疫学杂志, 2019, 42(5): 544-547. doi: 10.3760/cma.j.issn.1673-4394.2019.05.021 YIN Y, LING G C, FENG T W, et al. Research progress of depression and human immune inflammatory factors[J]. International Journal of immunology, 2019, 42(5): 544-547. doi: 10.3760/cma.j.issn.1673-4394.2019.05.021
[13]	李建瑞, 马冉冉, 樊新红, 等. 血清MDA, SOD, IL-1β, IFN-γ在血管性痴呆中的表达及与神经功能, 预后的关系[J]. 海南医学, 2020, 31(4): 433-437. doi: 10.3969/j.issn.1003-6350.2020.04.007 LI J R, MA R R, FAN X H, et al. Serum MDA, SOD, IL-1 β, IFN- γ expression in vascular dementia and its relationship with neurological function and prognosis[J]. Hainan Medical Journal, 2020, 31(4): 433-437. doi: 10.3969/j.issn.1003-6350.2020.04.007
[14]	王培琳, 张楠, 马思梦, 等. 免疫调节抗抑郁治疗研究进展[J]. 中华行为医学与脑科学杂志, 2020, 29(3): 284-285, 288. doi: 10.3760/cma.j.cn371468-20191204-00885 WANG P L, ZHANG N, MA S M, et al. Research progress of immunomodulatory antidepressant therapy[J]. Chinese Journal of Behavioral Medicine and Brain Science, 2020, 29(3): 284-285, 288. doi: 10.3760/cma.j.cn371468-20191204-00885
[15]	王宇红, 张尚霞, 马明玥, 等. 复方柴金解郁片对慢性应激抑郁大鼠HPA轴及炎症因子的影响[J]. 中国新药杂志, 2020, 29(5): 514-519. doi: 10.3969/j.issn.1003-3734.2020.05.006 WANG Y H, ZHANG S X, MA M Y, et al. Effects of compound Chaijin Jieyu tablet on HPA axis and inflammatory factors in rats with chronic stress depression[J]. Chinese Journal of New Drugs, 2020, 29(5): 514-519. doi: 10.3969/j.issn.1003-3734.2020.05.006
[16]	胡楠楠, 孙继军. 老年抑郁症患者神经递质、炎症因子水平与认知功能的关系[J]. 中国老年学杂志, 2020, 40(12): 2604-2606. doi: 10.3969/j.issn.1005-9202.2020.12.044 HU N N, SUN J J. Relationship between neurotransmitters, inflammatory factors and cognitive function in elderly patients with depression[J]. Chinese Journal of Gerontology, 2020, 40(12): 2604-2606. doi: 10.3969/j.issn.1005-9202.2020.12.044
[17]	刘卫花, 黄宏敏, 赵光峰. 补肾安神法对轻度抑郁伴焦虑失眠患者血清5-HT水平及SDS、SAS积分影响研究[J]. 辽宁中医杂志, 2019, 46(2): 303-306. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY201902030.htm LIU W H, HUANG H M, ZHAO G F. Effect of tonifying kidney and calming nerves on serum 5-HT level and SDS and SAS scores in patients with mild depression with anxiety and insomnia[J]. Liaoning Journal of Traditional Chinese Medicine, 2019, 46(2): 303-306. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY201902030.htm
[18]	胡全喜, 杨雪岭, 王德民, 等. 抑郁症患者认知功能障碍相关的神经生化指标分析[J]. 神经疾病与精神卫生, 2019, 19(4): 382-385. doi: 10.3969/j.issn.1009-6574.2019.04.013 HU Q X, YANG X L, WANG D M, et al. Analysis of neurobiochemical indexes related to cognitive impairment in patients with depression[J]. Neurological Diseases and Mental Health, 2019, 19(4): 382-385. doi: 10.3969/j.issn.1009-6574.2019.04.013
[19]	薛大力. 老年血管性痴呆病人的血浆同型半胱氨酸水平与认知功能、抑郁状况的关系[J]. 实用老年医学, 2017, 31(3): 224-226 https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA201703007.htm XUE D L. Relationship of homocysteine with cognitive impairment and depression in elderly patients with vascular dementia[J]. Practical Geriatrics, 2017, 31(3): 224-226. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA201703007.htm
[20]	程丽妞, 白树风, 武文娟, 等. 血清胱抑素C、IFN-γ水平在血管性痴呆患者中的变化及临床意义[J]. 中风与神经疾病杂志, 2019, 36(12): 1102-1104. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFSJ201912012.htm CHENG L N, BAI S F, WU W J, et al. Serum cystatin C, IFN-γ Changes and clinical significance of serum levels in patients with vascular dementia[J]. Journal of Stroke and Neurological Diseases, 2019, 36(12): 1102-1104. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFSJ201912012.htm