[1]袁晓梅,高新愿,杨小花.脑源性神经营养因子、肿瘤坏死因子-α和白细胞介素-6与慢性阻塞性肺疾病患者急性加重后抑郁及预后的关系[J].新乡医学院学报,2020,37(4):355-358.[doi:10.7683/xxyxyxb.2020.04.012]
　YUAN Xiaomei,GAO Xinyuan,YANG Xiaohua.Correlation between brain-derived neurotrophic factor,tumor necrosis factor-α,interleukin-6 and the depressive state of chronic obstructive pulmonary disease patients after acute exacerbation[J].Journal of Xinxiang Medical University,2020,37(4):355-358.[doi:10.7683/xxyxyxb.2020.04.012]
点击复制

脑源性神经营养因子、肿瘤坏死因子-α和白细胞介素-6与慢性阻塞性肺疾病患者急性加重后抑郁及预后的关系
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年4
页码:
355-358
栏目:
临床研究
出版日期:
2020-04-05

文章信息/Info

Title:
Correlation between brain-derived neurotrophic factor,tumor necrosis factor-α,interleukin-6 and the depressive state of chronic obstructive pulmonary disease patients after acute exacerbation
作者:
袁晓梅; 高新愿; 杨小花
（新乡医学院第一附属医院呼吸内科，河南　卫辉　453100）
Author(s):
YUAN Xiaomei; GAO Xinyuan; YANG Xiaohua
(Department of Respiratory,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
慢性阻塞性肺疾病; 抑郁; 脑源性神经营养因子; 肿瘤坏死因子-α; 白细胞介素-6
Keywords:
chronic obstructive pulmonary disease; depression; brain-derived neurotrophic factor; tumor necrosis factor-α; interleukin-6
分类号:
R563.9
DOI:
10.7683/xxyxyxb.2020.04.012
文献标志码:
A
摘要:
目的　探讨血清脑源性神经营养因子(BDNF)、肿瘤坏死因子-α(TNF-α）和白细胞介素-6(IL-6)与慢性阻塞性肺疾病(COPD)患者急性加重后伴发抑郁状态的关系及对其预后的影响。方法　选择新乡医学院第一附属医院呼吸内科2015年1月至2019年6月收治的164例COPD急性加重期患者为观察对象，患者均于入院后1 d内开始给予常规治疗，并于治疗前采用酶联免疫吸附试验法检测血清BDNF、TNF-α、IL-6水平；治疗前及治疗30 d 时检测肺功能，记录1 s用力呼气量占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FVC% pred)、1 s用力呼气量/用力肺活量(FEV1 /FVC)；治疗30 d时采用汉密尔顿抑郁量表 (HAMD)评定患者的抑郁症状。结果　治疗30 d时，164例患者中有89例（54.27%）患者无抑郁症状（非抑郁组），75例（45.73%）患者存在抑郁状态(抑郁组）；男、女性患者抑郁状态患病率分别为 47.3% (43/91) 、43.8%( 32/73),男、女患者抑郁状态患病率比较差异无统计学意义( χ2=0.082，P＞0.05)。2组患者的性别、年龄及病情程度比较差异无统计学意义(P＞0.05)。抑郁组患者治疗前血清BDNF水平显著低于非抑郁组（P＜0.05），血清TNF-α、IL-6水平显著高于非抑郁组（P＜0.05）。治疗前，2组患者的FEV1%pred、FVC%pred、FEV1/FVC值比较差异均无统计学意义（P＞0.05）；与治疗前比较，2组患者治疗后FEV1%pred、FVC%pred、FEV1/FVC值均显著增高（P＜0.05）；治疗后，抑郁组患者的FEV1%pred、FVC%pred、FEV1/FVC值均低于非抑郁组（P＜0.05）。抑郁组患者治疗前血清BDNF水平与 HAMD评分呈负相关( r=-0.625，P＜0.01)，与治疗30 d的FEV1%pred、FVC%pred、FEV1/FVC值均呈正相关(r=0.575、0.601、0.647，P＜0.01)；抑郁组患者治疗前血清TNF-α和IL-6水平与 HAMD均呈正相关(r=0.565、0.643，P<0.01)，与治疗30 d的FEV1%pred、FVC%pred、FEV1/FVC均呈负相关( r=-0.585、-0.632、-0.715，-0.624、-0.517、-0.825，P＜0.01)。结论　COPD急性加重期患者血清BDNF、TNF-α、IL-6水平可能与抑郁状态的发生有关，并影响其肺功能的改善。
Abstract:
Objective　To investigate the correlation between the serum brain-derived neurotrophic factor (BDNF),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and the depressive state of chronic obstructive pulmonary disease (COPD) patients after acute exacerbation and their influence on the prognosis of patients.Methods　One hundred and sixty-four patients in acute exacerbation period of COPD admitted to the Department of Respiratory,the First Affiliated Hospital of Xinxiang Medical University from January 2015 to June 2019 were selected as the subjects.All patients were given routine treatment within 1 day after admission,and the serum BDNF,TNF - α,IL-6 levels were measured by enzyme-linked immunosorbent assay before treatment;the ulmonary function was measured before and 30 days after treatment,and the percentage of forced expiratory volume in one second to predicted value (FEV1% pred),the percentage of forced vital capacity to expected(FVC% pred)and the forced expiratory volume in one second /forced vital capacity (FEV1/FVC) were recorded；the depression symptoms of patients was assessed by Hamilton depression scale (HAMD) at 30 days after treatment.Results　After 30 days treatment,89 (54.27%) patients had no depressive symptoms (non depressive group) and 75 (45.73%) patients had depressive state (depression group) among the 164 patients.The prevalence of depressive state in male and female patients was 47.3% (43 / 91),43.8% (32 / 73) respectively;there was no statistic difference in the prevalence of depressive state between male and female patients (χ2　= 0.082，P＞0.05).There was no significant difference in gender,age and disease severity between the two groups (P＞0.05).Before treatment,the serum level of BDNF of patients in depression group was significantly lower than that in the non depression group (P＜0.05),and the serum levels of TNF-αand IL-6 of patients in the depression group were significantly higher than those in the non depression group (P＜0.05).Before treatment,there was no significant difference in FEV1%pred,FVC%pred and FEV1/FVC between the two groups (P＞0.05).The FEV1%pred,FVC%pred and FEV1/FVC of patients after treatment were significantly higher than those before treatment in the two groups (P＜0.05).After treatment,the FEV1%pred,FVC%pred and FEV1/FVC of patients in the depression group were lower than those in the non depression group (P<0.05).The serum level of BDNF was negatively correlated with HAMD score (r=-0.625，P＜0.01) and was positively correlated with FEV1%pred,FVC%pred,FEV1/FVC in depression group (r=0.575,0.601,0.647;P＜0.01).The serum levels of TNF-αand IL-6 were positively correlated with HAMD score (r=0.565,0.643;P<0.01),and were negatively correlated with FEV1%pred,FVC%pred,FEV1/FVC in depression group (r=-0.585,-0.632,-0.715,-0.624,-0.517,-0.825；P＜0.01).Conclusion　The BDNF,TNF-α and IL-6 levels in serum of acute exacerbation of COPD patients may be related to depression and can effect the improvement of pulmonary function.

参考文献/References:

［1］　KOLSUM U，ROY K，STARKEY C，et al.The repeatability of interleukin-6，tumor necrosis factor-α，and C-reactive protein in COPD patients over one year［J］.Int J Chron Obstruct Pulmon Dis，2009，4(15):149-156.
［2］　赵新国，黄利华，黄捷晖，等.慢性阻塞性肺疾病患者情绪状态与BODE指数的关系［J］.江苏医药，2014，40(20):2406-2408.
［3］　王艳婕，曹威，李庆丽，等.阿戈美拉汀联合解郁丸治疗对抑郁症患者炎症因子和脑源性神经营养因子的影响［J］.中国慢性病预防与控制，2020，28(1):61-63.
［4］　LUO L，LI C，DU X，et al．Effect of aerobic exercise on BDNF/proBDNF expression in the ischemic hippocampus and depression recovery of rats after stroke［J］.Behav Brain Ｒes，2019，362: 323-331．
［5］　中华医学会呼吸病学分会慢性阻塞性肺疾病学组．慢性阻塞性肺疾病诊治指南(2013年修订版) ［J］．中国医学前沿杂志:电子版，2014，6(2):67-80．
［6］　袁晓梅，李华旭，孙致远，等.N-乙酰半胱氨酸对慢性阻塞性肺疾病急性加重期患者肺功能及血清炎性因子的影响［J］.新乡医学院学报，2018，35(4):306-309.
［7］　LIU Y M，SHEN J D，XU L P，et al．Ferulic acid inhibits neuro-inflamma tion in mice exposed to chronic unpredictable mild stress［J］.Int Immunopharmacol，2017，45:128-134．
［8］　张晓飞，刘兴宇，崔建忠，等.血清脑源性神经营养因子水平对保守治疗的高血压脑出血患者抑郁情绪的影响［J］.中国脑血管病杂志，2019，16(9):466-470.
［9］　杨英杰,刘茂航,游芳馨,等.前炎性细胞因子在抑郁症中的作用［J］.医学综述,2017,23(22):4393-4396.
［10］　BARCZOK M.COPD-smoking is not the only risk factor［J］.MMW Fortschr Med,2019,161(13):66-68.

相似文献/References:

[1]藏燕军,赵敏． 陈兴彩.甲状腺机能亢进患者l14例生活事件调查[J].新乡医学院学报,2001,18(02):144.
[2]史册.慢性阻塞性肺疾病急性发作期的营养支持治疗[J].新乡医学院学报,2001,18(06):444.
[3]皇甫秀荣,罗开国,肖志坚.肺结核患者抑郁状态的原因分析[J].新乡医学院学报,2001,18(04):284.
[4]袁晓梅,孙 云,袁宇.慢性阻塞性肺疾病肺心病患者血浆内皮素测定的临床价值[J].新乡医学院学报,2002,19(04):273.
[5]吕文国,宋信英,王艳玲.假性眩晕合并抑郁78 例分析[J].新乡医学院学报,2003,20(04):274.
[6]吕文国,宋信英,王艳玲.假性眩晕合并抑郁78例分析[J].新乡医学院学报,2003,20(04):274.
[7]郭志强.慢性阻塞性肺疾病60例院内获得性真菌感染与耐药性分析 [J].新乡医学院学报,2006,23(02):000.
[8]金凤羽,阮祥燕.女性围绝经期抑郁新进展 [J].新乡医学院学报,2006,23(01):000.
[9]张朝辉,宋景贵,王夏红,等.腔隙性脑梗死60 例抑郁情绪及P300 电位的对照观察[J].新乡医学院学报,2006,23(01):000.
[10]程思远.慢性阻塞性肺疾病继发真菌感染65例病原菌分布及耐药性分析[J].新乡医学院学报,2009,26(01):073.

更新日期/Last Update: 2020-04-05