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向娇娇, 洪素, 冉柳毅, 等. 舍曲林对首发重度抑郁症青少年患者血清炎症因子的影响研究[J]. 四川大学学报(医学版), 2023, 54(2): 310-315. DOI: 10.12182/20230360204
引用本文: 向娇娇, 洪素, 冉柳毅, 等. 舍曲林对首发重度抑郁症青少年患者血清炎症因子的影响研究[J]. 四川大学学报(医学版), 2023, 54(2): 310-315. DOI: 10.12182/20230360204
XIANG Jiao-jiao, HONG Su, RAN Liu-yi, et al. Effect of Sertraline on Serum Cytokine Levels in Adolescents With First-Episode Major Depressive Disorder[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(2): 310-315. DOI: 10.12182/20230360204
Citation: XIANG Jiao-jiao, HONG Su, RAN Liu-yi, et al. Effect of Sertraline on Serum Cytokine Levels in Adolescents With First-Episode Major Depressive Disorder[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(2): 310-315. DOI: 10.12182/20230360204

舍曲林对首发重度抑郁症青少年患者血清炎症因子的影响研究

Effect of Sertraline on Serum Cytokine Levels in Adolescents With First-Episode Major Depressive Disorder

  • 摘要:
      目的  探讨首发重度抑郁症(major depressive disorder, MDD)青少年患者药物治疗后的血清炎症因子变化以及舍曲林疗效的预测因素。
      方法  本研究纳入61例首发未用药的MDD青少年患者(MDD组)和55例健康青少年(HC组)。MDD组患者在入组后予盐酸舍曲林片治疗8周,健康对照组不予任何治疗。MDD组分别在基线和治疗后8周进行采集血样检测血清中炎症因子水平和临床资料评定〔17项汉密尔顿抑郁量表(17-items Hamilton Depression Scale, HAMD-17)和心理弹性量表(Connor-Davidson Resilience Scale, CD-RISC)〕,HC组仅在基线期采血检测和临床资料采集。分析MDD组炎症因子水平与抑郁严重程度的相关性,并进行MDD组HAMD-17的逐步线性回归,寻找能预测舍曲林疗效的血清学指标。
      结果  基线时MDD组的IL-1β和IL-6水平高于HC组(P均<0.0001),TNF-α水平低于HC组(P=0.006)。经过8周用药后,MDD组IL-1β、IL-6均下降,TNF-α水平较治疗前升高,HAMD-17、CD-RISC总分、坚韧、相信直觉及控制得分均升高。应答组和无应答组的基线期血清炎症因子水平无明显差异。治疗前后的IL-6水平与治疗前后的CD-RISC及其相信直觉因子评分弱相关。基线期间IL-1β、TNF-α水平对治疗后的HAMD-17评分影响无统计学意义。
      结论  青少年MDD患者血清炎症因子与健康青少年存在明显差异,IL-6与抑郁症严重程度相关,但尚不足以支持其作为预测舍曲林抗抑郁疗效的指标。

     

    Abstract:
      Objective  To investigate the changes in serum inflammatory cytokines and the predictive factors for the efficacy of sertraline following medication therapy in adolescents with first-episode major depressive disorder (MDD).
      Methods  A total of 61 adolescent patients with first-episode drug-naïve MDD were enrolled for the MDD group and 55 healthy adolescents were enrolled for the healthy control (HC) group. Sertraline tablets were administered to the MDD group for 8 weeks after enrollment, while no medication was given to the HC group. In the MDD group, blood samples were collected to measure the cytokine levels and clinical data, including scores for the 17-item Hamilton Depression Scale (HAMD-17) and the Connor-Davidson Resilience Scale (CD-RISC), were assessed at baseline and at the end of the 8-week medication, whereas in the HC group, blood samples and clinical data were collected only at baseline. The correlation between the levels of serum inflammatory cytokines and depression severity in the MDD group was analyzed and stepwise linear regression of HAMD-17 in the MDD group was performed to find serologic indicators that could be used to predict the efficacy of sertraline.
      Results  At baseline, the levels of interleukin (IL)-1β and IL-6 in the MDD group were significantly higher than those in the HC group (all P<0.0001), while the tumor necrosis factor (TNF)-α level in the MDD group was significantly lower than that in the HC group (P=0.006). After 8 weeks of medication treatment, the MDD group showed decreased levels of IL-1β and IL-6 and increased level of TNF-α compared to the pre-treatment levels. In addition, the HAMD-17 score, CD-RISC total score, and scores for perceived competence, trust and tolerance, and control, three factors of CD-RISC, all improved after treatment. There was no significant difference in serum cytokine levels at baseline between the subgroup showing response to the treatment and the non-responding subgroup. There was a weak correlation between IL-6 levels before and after treatment and CD-RISC scores and the scores for the trust and tolerance factor of CD-RISC before and after treatment. The baseline IL-1β and TNF-α levels did not show significant effect on posttreatment HAMD-17 scores.
      Conclusions  Serum cytokine levels of adolescents with first-episode MDD differ significantly from those of healthy adolescents. Although IL-6 was found to be correlated with depression severity, there was not enough support for it to be used as a predictor of the antidepression efficacy of sertraline.

     

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