CAJ | 학술논문

目的探讨抑郁症首次发病患者外周血内皮祖细胞(endothelial progenitor cells,EPCs)数量和功能的变化及其与血压、血糖、血脂、炎症因子等各因素的关系.方法选择符合《中国精神疾病分类与诊断标准(第3版)》抑郁症诊断标准,且24项汉密尔顿抑郁量表(HAMD24)评分≥21分的抑郁症首次发病患者30例(患者组)及年龄和性别匹配的健康志愿者(对照组)30名.采用HAMD24评定抑郁症状严重程度,使用流式细胞检测仪检测外周血循环EPCs数量,采用Ficoll密度梯度离心法分离培养外周血单个核细胞,采用MTT比色法检测细胞增殖功能,采用酶标化学发光免疫法检测血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平,采用免疫透射比浊法检测血清超敏C反应蛋白(hs-CRP)水平；采用Spearman相关分析评价IL-6、TNF-α、hs-CRP水平与循环EPCs数量的关系,采用多元线性回归分析评价一般临床资料和HAMD评分与循环EPCs数量的关系.结果 (1)患者组外周血EPCs CD34+ CD133+ KDR+细胞数量[(13.32±5.65) ×103个/L]和细胞增殖率[(0.44±0.04)％]低于对照组[(24.39±9.94)×103个/L、(0.61±0.05)％],血清IL-6水平[(8.76±3.18) ng/L]和TNF-α水平[(14.95 ±5.54) ng/L]高于对照组[(3.11±3.18)、(4.67±2.23) ng/L],差异均有统计学意义(t=-6.69、-14.23、5.31、4.22,均P＜0.05)；(2) Spearman相关分析显示,患者组IL-6(r=-0.441、-0.529)和TNF-α水平(r=-0.433、-0.313)与循环EPCs的数量和增殖率呈负相关(均P ＜0.05)；(3)多元线性逐步回归分析显示,HAMD总分和IL-6水平是循环EPCs数量的独立影响因素(均P＜0.05).结论抑郁症首次发病患者EPCs数量减少、功能减退,HAMD总分及IL-6水平是循环EPCs的独立影响因素.
목적 탐토억욱증수차발병환자외주혈내피조세포(endothelial progenitor cells,EPCs)수량화공능적변화급기여혈압、혈당、혈지、염증인자등각인소적관계.방법 선택부합《중국정신질병분류여진단표준(제3판)》억욱증진단표준,차24항한밀이돈억욱량표(HAMD24)평분≥21분적억욱증수차발병환자30례(환자조)급년령화성별필배적건강지원자(대조조)30명.채용HAMD24평정억욱증상엄중정도,사용류식세포검측의검측외주혈순배EPCs수량,채용Ficoll밀도제도리심법분리배양외주혈단개핵세포,채용MTT비색법검측세포증식공능,채용매표화학발광면역법검측혈청백세포개소-6(IL-6)화종류배사인자-α(TNF-α)수평,채용면역투사비탁법검측혈청초민C반응단백(hs-CRP)수평；채용Spearman상관분석평개IL-6、TNF-α、hs-CRP수평여순배EPCs수량적관계,채용다원선성회귀분석평개일반림상자료화HAMD평분여순배EPCs수량적관계.결과 (1)환자조외주혈EPCs CD34+ CD133+ KDR+세포수량[(13.32±5.65) ×103개/L]화세포증식솔[(0.44±0.04)％]저우대조조[(24.39±9.94)×103개/L、(0.61±0.05)％],혈청IL-6수평[(8.76±3.18) ng/L]화TNF-α수평[(14.95 ±5.54) ng/L]고우대조조[(3.11±3.18)、(4.67±2.23) ng/L],차이균유통계학의의(t=-6.69、-14.23、5.31、4.22,균P＜0.05)；(2) Spearman상관분석현시,환자조IL-6(r=-0.441、-0.529)화TNF-α수평(r=-0.433、-0.313)여순배EPCs적수량화증식솔정부상관(균P ＜0.05)；(3)다원선성축보회귀분석현시,HAMD총분화IL-6수평시순배EPCs수량적독립영향인소(균P＜0.05).결론 억욱증수차발병환자EPCs수량감소、공능감퇴,HAMD총분급IL-6수평시순배EPCs적독립영향인소.
Objective To detect the number and function changes of endothelial progenitor cells (EPCs) from peripheral blood in patients with first-episode depression and explore their correlation with blood pressure,glucose,lipids,inflammation.Methods The study included thirty first-episode depression patients and 30 healthy controls.The Hamilton Depression Rating Scale-24 (HAMD24) was used to assess the severity of depression.Peripheral blood EPCs were counted by flow cytometry.Mononuclear cells (MNCs) was isolated from peripheral blood by ficoll density-gradients centrifugation.After 7 days of culture,EPC proliferation activity was determined by MTT assay.The plasma levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 were assayed by using enzyme-labeled chemiluminescent sequential immunometric assay.Additionally,the high-sensitive C-reactive protein (hs-CRP) was detected by turbidimetric immunoassay.Results (1) Number and function activity of EPCs in patients were significantly lower than the controls [(13.32 ± 5.65) × 103 vs.(24.39 ± 9.94) × 103,(0.44 ± 0.04) ％ vs.(0.61 ±0.05) ％,t =-6.69,-14.23,P ＜ 0.05].(2) Significant increase was observed in serum IL-6 and TNF-α level in patients [(8.76 ± 3.18),(14.95 ± 5.54) ng/L] compared with controls [(3.11 ± 3.18),(4.67 ±2.23) ng/L,t =5.31,4.22,P ＜0.05] and these had negative correlation with the number and proliferation activity of EPCs.(3) By multiple linear stepwise regression analysis,HAMD and IL-6 were the independent factors affecting EPCs number (P ＜ 0.05).Conclusions The number and proliferation activity of EPCs are probably decreased in patients with first-episode depression,and neovascularization and repairment of damaged endothelium may be impaired in these patients,which could increase risk of coronary heart disease.