摘要
目的 研究经聚乙二醇干扰素α-2b治疗后,慢性乙肝患者外周血单个核细胞中p11 mRNA、糖皮质激素受体α(GRα) mRNA水平与抑郁症的相关性。方法 对60例慢性乙型肝炎患者进行编号,采用随机数字表法,随机分为观察组和对照组各30例,均常规给予护肝和抗病毒治疗,观察组在此基础上给予聚乙二醇干扰素α-2b治疗,疗程均为24周。采用汉密顿抑郁量表评估两组患者治疗前后的抑郁水平,检测外周血中的炎症因子、神经递质、p11 mRNA和GRα mRNA水平,并对两组患者p11 mRNA、GRα mRNA水平与抑郁症评分进行相关性分析。结果 两组患者治疗24周后,乙型肝炎病毒DNA应答率均较治疗前升高,且观察组高于对照组(P<0.05)。两组患者治疗24周后,汉密顿抑郁量表评分、血清γ干扰素和肿瘤坏死因子α水平均较治疗前升高(P<0.05或0.01),白细胞介素-4、血浆甲肾上腺素和5-羟色胺水平较治疗前降低(P<0.05或0.01),而观察组汉密顿抑郁量表评分和抑郁症发生率均明显高于对照组(P<0.05)。两组患者治疗24周后,观察组外周血单个核细胞中p11 mRNA水平高于对照组(P<0.05),GRα mRNA水平则低于对照组(P<0.05),且观察组外周血单个核细胞中p11 mRNA与γ干扰素、TNF-α和汉密顿抑郁量表评分呈正相关性(P<0.01),GRα mRNA与血浆甲肾上腺素、5-羟色胺水平和汉密顿抑郁量表评分也呈正相关性(P<0.01)。结论 聚乙二醇干扰素α-2b治疗后慢性乙肝患者外周血单个核细胞中p11 mRNA表达明显升高,GRα mRNA表达明显降低,且与外周血炎症因子和神经递质表达密切相关,可能是导致抑郁症发生的重要原因。
Objective To study the correlation of p11 mRNA and GR mRNA levels in peripheral blood mononuclear cells(PBMC)and depression in patients with chronic hepatitis B(CHB)after PEG-IFN-α-2b treatment.Methods Sixty CHB patients were numbered and divided into observation(n=30)and control(n=30)group according to random number table,both groups received routine liver protection and antiviral therapy,on this basis observation group was plus PEG-IFNα-2b therapy,and the course of treatment was 24 weeks.Pre-and post-treatment scores of both groups on depression were assessed using the Hamilton Depression Scale(HAMD),levels of inflammatory factors,neurotransmitters,p11 mRNA and GRαmRNA in peripheral blood detected,and correlation analyses of p11 mRNA and GRαmRNA levels with depression scores conducted.Results After 24 week treatment response rates of the HBV DNA in both groups elevated compared with pre-treatment and that was higher in observation than in control group(P<0.05).After 24 week treatment scores on the HAMD and serum IFN-γand TNF-αlevels in both groups elevated compared with pre-treatment(P<0.05 or 0.01),levels of IL-4,plasma NE and 5-HT lowered(P<0.05 or 0.01),and score on the HAMD and incidence of depression were significantly higher in observation than in control group(P<0.05).After 24 week treatment p11 mRNA in the PBMC was higher in observation than in control group(P<0.05),GRαmRNA lower(P<0.05),in observation group p11 mRNA,IFN-γand TNF-αwere positively correlated to the HAMD scores(P<0.01),and so were GRαmRNA,NE and 5-HT(P<0.01).Conclusion The expression levels of p11 mRNA in the PBMC obviously elevate in CHB patients after PEG-IFN-α-2b treatment and GRαmRNA lower,which are closely related to the expression levels of inflammatory factors and neurotransmitters in peripheral blood,and may be an important cause of depression.
作者
庞盼姣
李长安
赵巍峰
王园园
李赢
Pang Panjiao;Li Chang'an;Zhao Weifeng;Wang Yuanyuan;Li Ying(First-author's address:Xinxiang Medical University,Xinxiang 453003,Henan,China;不详)
出处
《临床心身疾病杂志》
CAS
2023年第4期1-7,共7页
Journal of Clinical Psychosomatic Diseases
基金
国家自然科学基金资助项目(编号82003118)。
