抑郁症患者血浆髓鞘相关蛋白和炎性因子水平的研究

何漪; 庞剑月; 刘雨佳; 邓亚洁; 刘玉霞; 李恒芬

doi:10.16766/j.cnki.issn.1674-4152.002243

抑郁症患者血浆髓鞘相关蛋白和炎性因子水平的研究

doi: 10.16766/j.cnki.issn.1674-4152.002243

郑州大学第一附属医院精神医学科，河南郑州 450052

基金项目:

河南省医学科技攻关计划省部共建项目 SB201901012

详细信息

通讯作者:
李恒芬, E-mail: fcclihf@zzu.edu.cn

中图分类号: R446R395
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出版历程
- 收稿日期: 2021-01-26
- 网络出版日期: 2022-03-02

Levels of plasma myelin-associated proteins and inflammatory factors in patients with major depressive disorder

Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China

摘要

摘要: 目的比较首发未服药和复发性抑郁症患者外周血浆髓鞘相关蛋白及炎性因子与健康人群的差异。方法纳入2019年3月—2020年5月于郑州大学第一附属医院精神医学科就诊的抑郁症患者80例，其中首次发病未服药抑郁症患者40例为首发组，复发抑郁症患者40例为复发组，同期38例健康志愿者为对照组。采用酶联免疫吸附实验测定所有受试者的外周血浆髓鞘碱性蛋白(MBP)、髓鞘相关糖蛋白(MAG)、髓鞘少突胶质细胞糖蛋白(MOG)、C反应蛋白(CRP)、白介素-6(IL-6)和肿瘤坏死因子α(TNF-α)水平。使用汉密尔顿抑郁量表(HAMD-24)评估抑郁程度。结果复发组、首发组、对照组的MBP[(2.32±0.95)ng/mL、(1.92±0.91)ng/mL、(1.40±0.76)ng/mL]和TNF-α[(8.49±5.45)ng/mL、(6.30±4.71)ng/mL、(4.90±4.18)ng/mL]组间差异有统计学意义(F=10.824、5.510，均P＜0.05)；复发组高于首发组(t_MBP=4.646，P＜0.05；t_TNF-α=3.285，P＜0.05)，复发组高于对照组(t_MBP=2.069，P＜0.05；t_TNF-α=2.034，P＜0.05)，首发组MBP高于对照组(t=2.603，P＜0.05)。髓鞘相关蛋白及炎性因子与HAMD-24评分无相关性(均P＞0.05)。结论外周血浆的MBP有望作为判断抑郁症预后及神经髓鞘病理损伤严重程度的重要指标，TNF-α可能与抑郁症的复发有关。
- 抑郁症 /
- 髓鞘相关蛋白 /
- 炎性因子
Abstract: Objective To compare the levels of peripheral plasma myelin-associated protein and inflammatory factors between patients with first-episode untreated and recurrent major depressive disorder and healthy people. Methods A total of 118 subjects in our hospital from March 2019 to May 2020 were recruited, including 40 patients with first-episode untreated major depressive disorder (first-episode group), 40 patients with recurrent major depressive disorder (recurrent group) and 38 healthy controls (control group). The levels of peripheral plasma myelin basic protein (MBP), myelin-associated glycoprotein, myelin oligodendrocyte glycoprotein, C-reactive protein, interleukin-6 and tumour necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay. The 24-item Hamilton Depression scale (HAMD-24) was used to score the degree of depression in all patients. Results Statistically significant differences were observed in the levels of MBP amongst the three groups [recurrent group (2.32±0.95) ng/mL; first-episode group (1.92±0.91) ng/mL; control group (1.40±0.76) ng/mL] and TNF-α [recurrent group (8.49±5.45) ng/mL; first-episode group (6.30±4.71) ng/mL; control group (4.90±4.18) ng/mL, F_MBP=10.824, P < 0.05; F_TNF-α=5.510, P < 0.05]. The levels of MBP and TNF-α in the recurrent group were significantly higher than those in the first-episode group (t_MBP=4.646, P < 0.05; t_TNF-α=3.285, P < 0.05), whilst the levels of MBP and TNF-α in the recurrent group were significantly higher than those in the control group (t_MBP=2.069, P < 0.05; t_TNF-α=2.034, P < 0.05). The MBP of the first-episode group was significantly higher than that of the control group (tMBP=2.603, P < 0.05). No significant correlation was observed between the levels of myelin-associated protein, inflammatory factors and HAMD-24 scores. Conclusion The level of MBP in peripheral plasma may be an important biomarker to determine the prognosis of depression and the severity of pathological injury of the nerve myelin sheath. The level of TNF-α may be related to the recurrence of major depressive disorder.
- Major depressive disorder /
- Myelin-associated proteins /
- Inflammatory factors

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表 1 3组研究对象一般资料及抑郁程度评分比较

组别	例数	性别(男/女, 例)	年龄(x±s, 岁)	受教育年限(x±s, 年)	HAMD-24评分(x±s, 分)
MDD首发组	40	19/21	25.20±7.91	11.30±3.13	33.87±8.46
MDD复发组	40	16/24	25.53±7.78	11.08±2.63	37.43±9.43
健康对照组	38	18/20	25.37±7.78	11.92±3.66
统计量		0.591^a	0.023^b	0.746^b	-1.772^c
P值		0.744	0.977	0.476	0.080
注：^a为χ²值，^b为F值，^c为t值。

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表 2 3组研究对象髓鞘相关蛋白和炎性因子比较

组别	例数	MBP(x±s, ng/mL)	MAG[M(P₂₅, P₇₅), ng/mL]	MOG[M(P₂₅, P₇₅), ng/mL]	CRP[M(P₂₅, P₇₅), mg/L]	IL-6[M(P₂₅, P₇₅), pg/mL]	TNF-α(x±s, pg/mL)
MDD首发组	40	1.92±0.91^a	0.11(0.06, 0.21)	92.81(60.62，141.20)^a	1.52(0.89, 1.64)	7.02(1.81，11.71)	6.30±4.71
MDD复发组	40	2.32±0.95^ab	0.14(0.10, 0.32)	103.57(73.53，159.92)^a	2.18(0.90, 2.41)^a	7.16(3.00，18.63)	8.49±5.45^ab
健康对照组	38	1.40±0.76	0.13(0.08, 0.16)	68.51(41.84，90.10)	1.13(0.83, 1.06)	4.32(1.85，10.36)	4.90±4.18
统计量		10.824^c	5.115^d	15.937^d	13.979^d	5.157^d	5.510^c
P值		< 0.001	0.077	< 0.001	0.001	0.076	0.005
注：与健康对照组比较，^aP < 0.05；与MDD首发组比较，^bP < 0.05。^c为F值，^d为H值。

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表 3 髓鞘相关蛋白、炎性因子与HAMD-24评分的相关性(r值)

组别	MBP	MAG	MOG	CRP	IL-6	TNF-α
MDD首发组	0.130	0.062	0.118	0.014	0.039	0.204
MDD复发组	0.189	0.216	0.070	0.190	0.299	0.026
注：均P＞0.05。

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