菏泽医学专科学校学报
菏澤醫學專科學校學報
하택의학전과학교학보
JOURNAL OF HEZE MEDICAL COLLEGE
2015年
3期
11-14,23
,共5页
冠心病/治疗%冠心病/并发症%抑郁症/治疗%抑郁症/病因学%免疫学%炎性因子
冠心病/治療%冠心病/併髮癥%抑鬱癥/治療%抑鬱癥/病因學%免疫學%炎性因子
관심병/치료%관심병/병발증%억욱증/치료%억욱증/병인학%면역학%염성인자
Coronary heart disease/therapy%Coronary heart disease/complications%Depression/therapy%Depression/etiology%Immunology%Inflammatory cytokines
目的 探讨冠心病伴抑郁症患者治疗前后免疫及炎性因子变化情况.方法 选择冠心病患者126例,采用CCIVID-3抑郁发作标准,汉密尔顿抑郁量表(HAIVID-17)评分.分为单纯冠心病组66例,冠心病伴抑郁症组60例;另外选择30例健康查体组和单纯抑郁症组作对照.所有患者治疗前后均采集晨起空腹静脉血10 mL各一次.对细胞免疫、体液免疫、红细胞、肿瘤坏死因子、超敏C反应蛋白、脑利钠素及白细胞介素-18等进行检测.细胞免疫采用流式细胞仪、酶联免疫法、速率散射免疫法、免疫比浊法进行检测.冠心病治疗在常规治疗的基础上加用丹参多酚注射液200 mg,每日一次.单纯性抑郁症患者采用阿米替林治疗.统计学处理采用方差分析,t检验.结果 体液免疫:1)冠心病者IgG、IgM、IgA、IgE、C3、C4与对照组比较均有不同程度的升高, IgG、IgE、C3、C4,P均<0.01,有显著性差异;IgM、IgA虽无显著性差异,但也有升高趋势.治疗后IgG、C3、C4与治疗前比较有明显的恢复P<0.05,有显著性差异;IgM、IgA、IgE治疗前后比较虽无显著性差异,但也有恢复趋势.2 )冠心病伴抑郁症IgM、IgE、C3、C4与对照组比较P<0.01~0.001,有显著性差异.3 )单纯抑郁症患者IgE与对照组比较P<0.01,其他均有升高,但无显著性差异;治疗前后比较只有C3有显著性差异P<0.05.细胞免疫:1 )单纯冠心病组与冠心病组CD3、CD4、CD8和CD4/CD8比值治疗前与对照组比较P<0.05~0.001,有显著性差异.同组治疗前后比较C4、CD4/CD8比值P<0.01.2 )单纯抑郁症患者治疗前与对照组比较P<0.01~0.001.同组治疗前后P<0.01.红细胞免疫:单纯冠心病组、冠心病伴抑郁症组及单纯抑郁症组治疗前与对照组比较P<0.01~0.001,有显著性差异.治疗后同组比较单纯冠心病组和冠心病伴抑郁症组均有明显恢复P<0.05~0.01.单纯抑郁症组治疗前后促肿瘤红细胞免疫花环率、红细胞免疫亲和力受体及红细胞C3b受体花环率有明显的恢复P<0.05~0.01.炎性因子各组TNF-α、BNP、hs-CRP均有升高,治疗前与对照组比较各项均有显著性差异P<0.01~P<0.001,单纯抑郁症组IL-18无显著性差异.同组治疗前后比较TNF-α、IL-18、BNP、hs-CRP冠心病组及冠心病伴抑郁症组明显恢复P<0.01~0.001;单纯性抑郁症治疗前后比较TNF-αP<0.001,IL-18、BNP、hs-CRP均有一定的回升,但无显著性差异.结论 单纯性冠心病组、冠心病伴抑郁症及单纯性抑郁症体液免疫、细胞免疫、红细胞免疫及致炎因子均有不同的变化,且贯穿疾病的全过程;通过有效治疗均有恢复,说明有效治疗可是组织细胞修复.
目的 探討冠心病伴抑鬱癥患者治療前後免疫及炎性因子變化情況.方法 選擇冠心病患者126例,採用CCIVID-3抑鬱髮作標準,漢密爾頓抑鬱量錶(HAIVID-17)評分.分為單純冠心病組66例,冠心病伴抑鬱癥組60例;另外選擇30例健康查體組和單純抑鬱癥組作對照.所有患者治療前後均採集晨起空腹靜脈血10 mL各一次.對細胞免疫、體液免疫、紅細胞、腫瘤壞死因子、超敏C反應蛋白、腦利鈉素及白細胞介素-18等進行檢測.細胞免疫採用流式細胞儀、酶聯免疫法、速率散射免疫法、免疫比濁法進行檢測.冠心病治療在常規治療的基礎上加用丹參多酚註射液200 mg,每日一次.單純性抑鬱癥患者採用阿米替林治療.統計學處理採用方差分析,t檢驗.結果 體液免疫:1)冠心病者IgG、IgM、IgA、IgE、C3、C4與對照組比較均有不同程度的升高, IgG、IgE、C3、C4,P均<0.01,有顯著性差異;IgM、IgA雖無顯著性差異,但也有升高趨勢.治療後IgG、C3、C4與治療前比較有明顯的恢複P<0.05,有顯著性差異;IgM、IgA、IgE治療前後比較雖無顯著性差異,但也有恢複趨勢.2 )冠心病伴抑鬱癥IgM、IgE、C3、C4與對照組比較P<0.01~0.001,有顯著性差異.3 )單純抑鬱癥患者IgE與對照組比較P<0.01,其他均有升高,但無顯著性差異;治療前後比較隻有C3有顯著性差異P<0.05.細胞免疫:1 )單純冠心病組與冠心病組CD3、CD4、CD8和CD4/CD8比值治療前與對照組比較P<0.05~0.001,有顯著性差異.同組治療前後比較C4、CD4/CD8比值P<0.01.2 )單純抑鬱癥患者治療前與對照組比較P<0.01~0.001.同組治療前後P<0.01.紅細胞免疫:單純冠心病組、冠心病伴抑鬱癥組及單純抑鬱癥組治療前與對照組比較P<0.01~0.001,有顯著性差異.治療後同組比較單純冠心病組和冠心病伴抑鬱癥組均有明顯恢複P<0.05~0.01.單純抑鬱癥組治療前後促腫瘤紅細胞免疫花環率、紅細胞免疫親和力受體及紅細胞C3b受體花環率有明顯的恢複P<0.05~0.01.炎性因子各組TNF-α、BNP、hs-CRP均有升高,治療前與對照組比較各項均有顯著性差異P<0.01~P<0.001,單純抑鬱癥組IL-18無顯著性差異.同組治療前後比較TNF-α、IL-18、BNP、hs-CRP冠心病組及冠心病伴抑鬱癥組明顯恢複P<0.01~0.001;單純性抑鬱癥治療前後比較TNF-αP<0.001,IL-18、BNP、hs-CRP均有一定的迴升,但無顯著性差異.結論 單純性冠心病組、冠心病伴抑鬱癥及單純性抑鬱癥體液免疫、細胞免疫、紅細胞免疫及緻炎因子均有不同的變化,且貫穿疾病的全過程;通過有效治療均有恢複,說明有效治療可是組織細胞脩複.
목적 탐토관심병반억욱증환자치료전후면역급염성인자변화정황.방법 선택관심병환자126례,채용CCIVID-3억욱발작표준,한밀이돈억욱량표(HAIVID-17)평분.분위단순관심병조66례,관심병반억욱증조60례;령외선택30례건강사체조화단순억욱증조작대조.소유환자치료전후균채집신기공복정맥혈10 mL각일차.대세포면역、체액면역、홍세포、종류배사인자、초민C반응단백、뇌리납소급백세포개소-18등진행검측.세포면역채용류식세포의、매련면역법、속솔산사면역법、면역비탁법진행검측.관심병치료재상규치료적기출상가용단삼다분주사액200 mg,매일일차.단순성억욱증환자채용아미체림치료.통계학처리채용방차분석,t검험.결과 체액면역:1)관심병자IgG、IgM、IgA、IgE、C3、C4여대조조비교균유불동정도적승고, IgG、IgE、C3、C4,P균<0.01,유현저성차이;IgM、IgA수무현저성차이,단야유승고추세.치료후IgG、C3、C4여치료전비교유명현적회복P<0.05,유현저성차이;IgM、IgA、IgE치료전후비교수무현저성차이,단야유회복추세.2 )관심병반억욱증IgM、IgE、C3、C4여대조조비교P<0.01~0.001,유현저성차이.3 )단순억욱증환자IgE여대조조비교P<0.01,기타균유승고,단무현저성차이;치료전후비교지유C3유현저성차이P<0.05.세포면역:1 )단순관심병조여관심병조CD3、CD4、CD8화CD4/CD8비치치료전여대조조비교P<0.05~0.001,유현저성차이.동조치료전후비교C4、CD4/CD8비치P<0.01.2 )단순억욱증환자치료전여대조조비교P<0.01~0.001.동조치료전후P<0.01.홍세포면역:단순관심병조、관심병반억욱증조급단순억욱증조치료전여대조조비교P<0.01~0.001,유현저성차이.치료후동조비교단순관심병조화관심병반억욱증조균유명현회복P<0.05~0.01.단순억욱증조치료전후촉종류홍세포면역화배솔、홍세포면역친화력수체급홍세포C3b수체화배솔유명현적회복P<0.05~0.01.염성인자각조TNF-α、BNP、hs-CRP균유승고,치료전여대조조비교각항균유현저성차이P<0.01~P<0.001,단순억욱증조IL-18무현저성차이.동조치료전후비교TNF-α、IL-18、BNP、hs-CRP관심병조급관심병반억욱증조명현회복P<0.01~0.001;단순성억욱증치료전후비교TNF-αP<0.001,IL-18、BNP、hs-CRP균유일정적회승,단무현저성차이.결론 단순성관심병조、관심병반억욱증급단순성억욱증체액면역、세포면역、홍세포면역급치염인자균유불동적변화,차관천질병적전과정;통과유효치료균유회복,설명유효치료가시조직세포수복.
Objective To explore the diagnosis and treatment of coronary heart disease patients with depression before and after the immune and inflammatory factor changes. Methods Choose 126 cases of coronary heart disease pa-tients, the use of a depressive episode 3 CCIVID standards, Hamilton depression rating scale (HAIVID a 17) score. Divid-ed into pure group of 66 cases of coronary heart disease, coronary heart disease with depression group of 60 cases;Also choose 30 cases of healthy physical examination and pure depression group were compared. All of the patients before and after treatment were collected since morning fasting venous blood 10 ml each time. To cellular immunity, humoral immuni-ty, red blood cells, tumor necrosis factor, hypersensitive c-reactive protein and brain natriuretic and interleukin- 18 for testing. Immune cells by flow cytometry, enzyme-linked immunoassay, rate scattering immune method, immune turbidi-metric method for testing. Coronary heart disease (CHD) treatment on the basis of conventional treatment combined with salvia miltiorrhiza polyphenol injection 200 mg, once daily. Simple with amitriptyline treatment of depression. Statistical processing using analysis of variance, t test. Results The humoral immune:1) coronary heart disease (CHD) IgG, IgM and IgA, IgE, C3 and C4 have varying degrees of increase compared with controls, IgG, IgE, C3 and C4, P<0.01, there are significant differences;IgM and IgA, though there was no significant difference, but also has a rising trend. IgG, C3 and C4 after treatment compared with before treatment had obvious recovery (P<0.05, there is significant difference;IgM and IgA, IgE, though there was no significant difference before and after the treatment, but also a recovery trend. 2) of coro-nary heart disease with depression IgM, IgE, C3 and C4 compared with control group (P<0.01~0.001), there is significant difference. IgE 3) simple depression patients compared with control group (P<0.01), other all have increased, but there was no significant difference;Before and after treatment was only C3 has significant differences (P<0.05). Cellular immu-nity:1) simple coronary heart disease and coronary heart disease group CD3, CD4, CD8 and CD4/CD8 ratio compared with the control group before treatment (P<0.05~0.001, there is significant difference. Group comparison C4, CD4/CD8 ratio before and after the treatment (P<0.01). 2) simple depression patients before treatment compared with control group (P<0.01~0.001). Group before and after treatment (P<0.01). Red blood cell immune:pure group of coronary heart dis-ease, coronary heart disease with depression and pure depression groups before treatment compared with control group (P<0.01~0.001), there is significant difference. Treatment group after simple coronary heart disease and coronary heart dis-ease with depression group were obviously restore (P<0.05~0.01). Simple depression group to promote tumor wreath of red cell immune rates before and after treatment and RBC immune receptor affinity and wreath of red blood cell C3b recep-tor rate has obvious recovery (P<0.05 ~ 0.01)Inflammatory factor: Groups of TNF alpha, BNP, hs- CRP were higher, compared with the control group before treatment between groups had significant difference (P<0.01 ~ P<0.001), the pure IL-18 depression group there was no significant difference. Group before and after treatment comparison of TNF al-pha, IL-18, BNP, hs-CRP of coronary heart disease and coronary heart disease with depression group recovered (P<0.01~0.001);Simple depression before and after treatment comparison of TNF alpha(P<0.001)., IL-18, BNP, hs-CRP were recovered to a certain extent, but there was no significant difference. Conclusion Simple group coronary heart dis-ease, coronary heart disease with depression and simple depression humoral immunity, cellular immunity and RBC im-mune and inflammatory factors have different changes, and throughout the whole process of disease; Through effective treatment were restored, shows that effective treatment but tissue repair.