实用医学杂志 ›› 2022, Vol. 38 ›› Issue (12): 1522-1526.doi: 10.3969/j.issn.1006⁃5725.2022.12.015

• 临床研究 • 上一篇    下一篇

伴自杀自伤行为的青少年情感障碍患者炎性细胞因子水平对照研究

崔利军1 杨永涛2 崔伟1 张丽丽1 郭艳梅1    

  1. 1 河北省精神卫生中心(河北保定 071000);2 珠海市慢性病防治中心(广东珠海 519000)

  • 出版日期:2022-06-25 发布日期:2022-06-25
  • 基金资助:
    河北省财政厅、河北省卫生健康委政府资助临床医学优秀人才项目(编号:361014)

Inflammatory cytokines levels in affective disorder adolescents with or without suicidal/self ⁃injury behav⁃ ior:A comparative study

CUI Lijun*,YANG Yongtao,CUI Wei,ZHANG Lili,GUO Yanmei.   

  1. Hebei Mental⁃ Health Center,Baoding 071000,China

  • Online:2022-06-25 Published:2022-06-25

摘要:

目的 探索青少年情感障碍患者自杀/自伤行为与神经免疫炎性细胞因子的关系。方法 入组病例符合 DSM⁃5 单、双相障碍目前为抑郁发作的诊断标准,年龄为 15~24 岁,共 78 例,不伴自杀自伤 26 例,伴自杀自伤组 52 例,采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAHA)、32 项轻躁狂 症状清单(HCL⁃32)评定患者的临床症状,于入院次日清晨采集空腹静脉血,采用 ELISA 法测定样本的 炎性细胞因子水平。结果 伴自杀自伤组女性(75.00%)高于男性(25.00%)(χ2 = 4.875,P = 0.027)、平均年 龄(16.73 ± 2.09)岁小于不伴自杀自伤组(18.69 ± 2.46)岁(t = 3.683,P < 0.001);伴自杀自伤组抗炎细胞因 子中 IL⁃4(F = 9.261,P = 0.003)、IL⁃13(F = 4.462,P = 0.038)表达水平均低于不伴自杀自伤行为组。二项 logistic 回归分析:伴自杀自伤行为情感障碍患者的危险因素为年龄(OR = 0.504)、女性(OR = 9.141)、双相 Ⅱ型(OR = 3.235)、IL⁃4(OR = 0.964)、IL⁃13(OR = 0.952)。结论 双相Ⅱ型、女性、年龄偏小及 IL⁃4、IL⁃13 表达水平明显的降低是青少年情感障碍自杀自伤行为的独立危险因素。

关键词:

情感障碍, 自杀, 自伤, 炎性细胞因子, 白细胞介素4, 青少年

Abstract:

Objective To explore the relationship between suicidal/self⁃injury behaviors and the levels of inflammatory cytokines in adolescents with affective disorder. Methods Seventy ⁃eight adolescents with affective disorder aged 15 ~ 24,who met the current diagnostic criteria of major depressive episode and major depressive episode of DSM⁃5 bipolar disorder were included in the study,26 of them in the non⁃suicidal/self⁃injury group and 52 in the suicidal/self ⁃ injury group. Their clinical symptoms were assessed by the Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale(HAHA)and 32⁃item hypomania symptom Checklist(HCL⁃32). Fasting venous blood was collected in the next morning following admission,and the levels of inflammatory cytokines in the samples were determined by ELISA. Results In the suicidal/self ⁃injury behavior group,the number of female (75.00%)was significantly higher than the number of male(25.00%)(χ2 = 4.875;P = 0.027). The mean age in the suicidal/self⁃injury behavior group was significantly lower than that in the non⁃suicidal/self⁃injury behavior group [(16.73 ± 2.09)vs.(18.69 ± 2.46),t = 3.683;P < 0.001]. The expression levels of IL⁃4 and IL⁃13 in the anti⁃ inflammatory cytokines in the former were significantly lower than those in the latter(F = 9.261,P = 0.003;F = 4.462,P = 0.038,respectively). By binomial logistic regression analysis,the risk factors for the patients with suicidal/self⁃injury behavior were age(OR = 0.504),female(OR = 9.141),bipolar Ⅱ(OR = 3.235),IL⁃4(OR = 0.964),and IL⁃13(OR = 0.952). Conclusion Bipolar Ⅱ ,female,younger age and significantly decreased expression of IL⁃4 and IL⁃13 are independent risk factors for suicidal/self⁃injury behavior in adolescents with affec⁃ tive disorder. 

Key words:

affective disorder, suicide, self?injury, inflammatory cytokines, IL?4, adolescents