Jiang Donglin, Jiang Shengyang, Gong Fang, Yuan Fenglai, Zhao Peng, He Xinglong, Lv Guozhong, Chu Xing
Am Surg. 2018 Aug 1;84(8):1350-1354.
We aim to investigate the relation between depression, posttraumatic stress disorder (PTSD), and inflammatory factors in patients with severe burn injury. Psychological assessment was carried out using PTSD checklist (PCL) involving a 17-item self-report questionnaire (PCL-17) and the Hamilton Rating Scale for depression (HAMD-24). The serum IL-1β, IL-6, IL-8, and tumor necrosis factor-α (TNF-α) were determined using enzyme-linked immunosorbent assay. Correlation analysis was performed to analyze the correlation between the factors and scores of PTSD and depression. Compared with the PCL-17 score, HAMD-24 score, and inflammatory factors at month 3, a significant decrease was noticed in the PCL-17 score, HAMD-24 score, and inflammatory factors at months 6 and 9 (P < 0.01). For the HAMD-24 score, significant improvements were noticed in the anxiety/somatization, cognitive disorder, blocking, sleep disorders, and depression at months 3, 6, and 9. The levels of IL-1β, IL-8, and TNF-α were positively correlated with the PCL-17 score (P < 0.05). The levels of IL-1β, IL-6, IL-8, and TNF-α were positively correlated with the HAMD-24 score (P < 0.05). Patients with severe burn injury showed obvious stress alternation displaying specific depression-related characteristics, and inflammation may involve in the pathogenesis of PTSD and depression in burn patients.
我们旨在研究严重烧伤患者抑郁、创伤后应激障碍(PTSD)与炎症因子之间的关系。采用创伤后应激障碍检查表(PCL)进行心理评估,该检查表包含一份17项的自我报告问卷(PCL - 17)以及汉密尔顿抑郁评定量表(HAMD - 24)。采用酶联免疫吸附测定法测定血清白细胞介素 - 1β(IL - 1β)、白细胞介素 - 6(IL - 6)、白细胞介素 - 8(IL - 8)和肿瘤坏死因子 - α(TNF - α)。进行相关性分析以分析这些因素与创伤后应激障碍和抑郁评分之间的相关性。与第3个月时的PCL - 17评分、HAMD - 24评分及炎症因子相比,第6个月和第9个月时PCL - 17评分、HAMD - 24评分及炎症因子显著降低(P < 0.01)。对于HAMD - 24评分,在第3个月、第6个月和第9个月时,焦虑/躯体化、认知障碍、阻滞、睡眠障碍及抑郁方面有显著改善。IL - 1β、IL - 8和TNF - α水平与PCL - 17评分呈正相关(P < 0.05)。IL - 1β、IL - 6、IL - 8和TNF - α水平与HAMD - 24评分呈正相关(P < 0.05)。严重烧伤患者表现出明显的应激变化,呈现出特定的抑郁相关特征,炎症可能参与烧伤患者创伤后应激障碍和抑郁的发病机制。