Department of Cardiology, Linköping University Hospital, Linköping, Sweden. Department of Medicine and Health Sciences, Division of Cardiovascular Medicine, University of Linköping, Linköping, Sweden.
Am Heart J. 2011 Jun;161(6):1053-9. doi: 10.1016/j.ahj.2011.03.011. Epub 2011 May 11.
Depressive symptoms in patients with heart failure (HF) are common and might be associated with inflammation. No studies have examined both the cross-sectional and prospective association between inflammation and depressive symptoms in patients with HF with adequate correction for disease severity. The aim of this study was to describe if the cytokines interleukin-6 (IL-6) and C-reactive protein (CRP) are associated with depressive symptoms in hospitalized HF patients.
Data from 517 patients hospitalized for HF from the COACH study were analyzed on inflammation markers (IL-6 and CRP) and depressive symptoms (Center for Epidemiological Studies Depression-Scale).
Heart failure patients with depressive symptoms (n = 208, 40%) had significantly higher plasma values of IL-6 (median 12.8 pg/mL vs median 11.0 pg/mL, P = .018) and CRP (median 2.4 mg/mL vs median 2.1 mg/mL, P = .03) compared with the nondepressed patients. Structural equation modelling showed that the factor inflammation (including IL-6 and CRP) was associated with depressive symptoms (β = 0.18, P < .05) when left ventricular ejection fraction and plasma values brain natriuretic peptides were included in the model. A small negative (β = -0.18, P < .05) effect was found between inflammation at baseline and the change in depressive symptoms during the 18 months of follow-up.
Higher levels of inflammatory markers are independently associated with depressive symptoms in HF patients, even after correcting for disease severity. There is no clear relationship between inflammation at baseline and depressive symptoms during the 18 months of follow-up.
心力衰竭（HF）患者常伴有抑郁症状，且可能与炎症有关。既往研究未充分校正疾病严重程度，探讨炎症与 HF 患者抑郁症状之间的横断面及前瞻性关联。本研究旨在描述在充分校正疾病严重程度的情况下，心力衰竭住院患者的细胞因子白细胞介素 6（IL-6）和 C 反应蛋白（CRP）与抑郁症状之间的关系。
COACH 研究中 517 例因 HF 住院患者的数据用于分析炎症标志物（IL-6 和 CRP）和抑郁症状（流行病学研究中心抑郁量表）。
伴有抑郁症状的 HF 患者（n = 208，40%）的 IL-6（中位数 12.8 pg/mL 比中位数 11.0 pg/mL，P =.018）和 CRP（中位数 2.4 mg/mL 比中位数 2.1 mg/mL，P =.03）血浆值显著更高。结构方程模型显示，当模型中包含左心室射血分数和脑利钠肽血浆值时，炎症因子（包括 IL-6 和 CRP）与抑郁症状相关（β = 0.18，P <.05）。在 18 个月的随访期间，基线炎症与抑郁症状变化之间存在较小的负相关（β = -0.18，P <.05）。
即使在充分校正疾病严重程度后，较高水平的炎症标志物与 HF 患者的抑郁症状独立相关。在 18 个月的随访期间，基线炎症与抑郁症状之间无明确关系。
