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[老年抑郁症患者的一些炎症因子及免疫表型]

[Some inflammation factors and immunophenotypes of depression in elderly patients].

作者信息

Safarova T P, Yakovleva O B, Androsova L V, Simonov A N, Klyushnik T P

机构信息

Mental Health Research Center, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(2):53-58. doi: 10.17116/jnevro202012002153.

Abstract

AIM

To search for the immunological features of depressions in elderly patients, select certain immunophenotypes and analyze their possible connection with clinical and psychopathological features of depression of old age.

MATERIAL AND METHODS

The study included 55 inpatients of old age (median 68 years) with a depressive episode of mild or moderate severity. The control group consisted of 41 elderly people (median 67 years) without depressive disorders. Clinical, psychometric, immunological and statistical methods were used. The rating scales were HAMD-17 and MMSE. The activity of inflammatory and autoimmune markers, including enzymatic activity of leukocyte elastase (LE), α1-proteinase inhibitor (α1-PI), level of autoantibodies to neurospecific antigens S-100B and myelin basic protein, in the serum of patients and control subjects was determined.

RESULTS AND CONCLUSION

The scatter in the immunological parameters both in the direction of exceeding the average values and their decrease was shown in the group of depressed elderly patients compared to the controls. Cluster analysis revealed two immunophenotypes of elderly patients with depression. Immunophenotype A is a group of patients with increased PE activity and immunophenotype B is a group of patients with decreased LE activity (p<0.0000). Immunophenotype A includes patients with complex depressions, comorbid with anxiety and senesto-hypochondriac disorders. In immunophenotype B, patients with prolonged apatic/adynamic depressions (p<0.05), with an earlier onset and longer duration of the disease, with incomplete remissions and more burdened with cardiovascular diseases were more common (p<0.05).

摘要

目的

探寻老年抑郁症患者的免疫学特征,筛选特定免疫表型,并分析其与老年抑郁症临床及精神病理学特征之间的可能联系。

材料与方法

该研究纳入了55名老年住院患者(年龄中位数为68岁),均患有轻度或中度抑郁发作。对照组由41名无抑郁症的老年人(年龄中位数为67岁)组成。采用了临床、心理测量、免疫学及统计学方法。评定量表为汉密尔顿抑郁量表(HAMD - 17)和简易精神状态检查表(MMSE)。测定了患者及对照者血清中炎症和自身免疫标志物的活性,包括白细胞弹性蛋白酶(LE)、α1 - 蛋白酶抑制剂(α1 - PI)的酶活性,以及针对神经特异性抗原S - 100B和髓鞘碱性蛋白的自身抗体水平。

结果与结论

与对照组相比,老年抑郁症患者组的免疫参数在高于或低于平均值方向上均呈现出离散状态。聚类分析揭示了老年抑郁症患者的两种免疫表型。免疫表型A为一组PE活性升高的患者,免疫表型B为一组LE活性降低的患者(p < 0.0000)。免疫表型A包括伴有焦虑和衰老疑病症共病的复杂抑郁症患者。在免疫表型B中,病程较长的淡漠/无动力性抑郁症患者(p < 0.05)更为常见,这些患者起病较早、病程较长、缓解不完全且心血管疾病负担较重(p < 0.05)。

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