抑郁症患者血清紧密连结蛋白-5和内源性配体-13水平变化及其与病情发展和睡眠障碍的关系

doi:10.3969/j.issn.1006-5725.2024.12.011

摘要/Abstract

摘要：

目的探讨抑郁症患者血清紧密连结蛋白-5（claudin-5）和内源性配体-13（Apelin-13）水平变化及其与病情发展和睡眠障碍的关系。方法选取2021年6月至2023年7月期间酒泉市人民医院收治的128例抑郁症患者作为观察组，另选取同期体检者128例作为对照组。分析抑郁症患者血清claudin-5、Apelin-13表达水平与汉密顿抑郁量表（HAMD）评分的相关性以及血清claudin-5和Apelin-13对抑郁症患者病情严重程度的诊断价值。结果观察组患者血清claudin-5表达水平高于对照组，随病情严重程度的加重而升高（P < 0.05），与HAMD评分呈正相关（r = 0.713，P < 0.05），且睡眠障碍组患者血清claudin-5表达水平高于无睡眠障碍组（P < 0.05），Apelin-13表达水平变化趋势与之相反；年龄、首发抑郁年龄和claudin-5为抑郁症患者睡眠障碍的危险因素，Apelin-13为保护因素（P < 0.05）；血清claudin-5和Apelin-13联合检测优于各自单独检测（Z_{二者联合-claudin-5}=2.393、Z_{二者联合-Apelin-13}=1.964，P = 0.016、0.044）。结论抑郁症患者血清claudin-5和Apelin-13表达水平与病情发展及睡眠障碍有关，二者联合检测对重度抑郁症具有较高的诊断价值。

关键词: 抑郁症, 紧密连结蛋白-5, 内源性配体-13, 睡眠障碍

Abstract:

Objective To investigate the changes in serum levels of claudin-5 and Apelin-13 in patients with depression and their relationship with disease progression and sleep disorders. Methods A total of 128 patients with depression admitted to our hospital from June 2021 to July 2023 were selected as the study group， and another 128 patients who underwent physical examinations during the same period were selected as the control group. The correlation between the expression levels of serum claudin-5 and Apelin-13 in patients with depression and the Hamilton Depression Rating Scale （HAMD） score， as well as the diagnostic value of serum claudin-5 and Apelin-13 for the severity of depression in patients were analyzed. Results The expression level of claudin-5 in the serum of patients in study group was higher than that of the control group， which increased with the severity of the disease （P < 0.05） and was positively correlated with the HAMD score （r = 0.713， P < 0.05）. In addition， the expression level of claudin-5 in the serum of patients with sleep disorders was higher than that of those without sleep disorders （P < 0.05）， and the trend of changes in the expression level of Apelin-13 was opposite； Age， age at onset of depression， and claudin-5 were factors for sleep disorders in patients with depression， while Apelin-13 was a protective factor （P < 0.05）； The combined detection of serum claudin-5 and Apelin-13 is superior to their individual detection（Z_{combined detection - claudin-5} = 2.393， Z_{combined detection - Apelin-13} = 1.964， P = 0.016， 0.044）. Conclusion The expression levels of claudin-5 and Apelin-13 in serum of patients with depression were related to the progression of disease and the sleep disorders and the combined detection has high diagnostic value for severe depression.

Key words: depression, claudin-5, apelin-13, sleep disorders

中图分类号:

R749

丁志强,董强利,梁英,石文元. 抑郁症患者血清紧密连结蛋白-5和内源性配体-13水平变化及其与病情发展和睡眠障碍的关系[J]. 实用医学杂志, 2024, 40(12): 1677-1682.

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组别	例数	年龄（岁）	男性［例（%）］	BMI（kg/m²）	吸烟史［例（%）］
对照组	128	33.52 ± 5.72	60（46.87）	23.55 ± 3.49	42（32.81）
观察组	128	32.88 ± 5.05	51（39.84）	23.72 ± 3.12	38（29.68）
χ ² /t值		0.949	1.288	0.411	0.291
P值		0.344	0.256	0.682	0.590

组别	例数	claudin-5（ng/mL）	Apelin-13（ng/mL）	HAMD评分（分）
轻度组	58	61.22 ± 7.09	29.81 ± 3.71	11.73 ± 2.31
中度组	46	75.38 ± 7.83^a	24.55 ± 3.09^a	20.58 ± 2.92^a
重度组	24	84.11 ± 9.22^ab	20.03 ± 2.56^ab	27.55 ± 3.71^ab
F值		86.869	82.104	297.016
P值		< 0.001	< 0.001	< 0.001

组别	例数	claudin-5	Apelin-13
无睡眠障碍组	37	56.14 ± 6.53	32.11 ± 3.88
睡眠障碍组	91	76.61 ± 8.42	23.64 ± 2.91
t值		13.246	13.503
P值		< 0.001	< 0.001

组别	年龄（岁）		性别		婚姻状况
组别	＜35	≥35	男	女	有配偶	无配偶
无睡眠障碍组	27（35.53）	10（19.23）	17（33.33.）	20（25.97）	25（29.76）	12（27.27）
睡眠障碍组	49（64.47）	42（80.77）	34（66.67）	57（74.03）	59（70.24）	32（72.73）
χ ² 值	3.99		0.809		0.087
P值	0.046		0.369		0.768

指标	β	SE	Wald	P值	OR	95%CI
年龄	0.622	0.231	7.242	0.007	1.862	1.184 ~ 2.928
首发抑郁年龄	0.573	0.209	7.523	0.006	1.774	1.178 ~ 2.672
claudin-5	0.750	0.287	6.838	0.009	2.118	1.207 ~ 3.717
Apelin-13	-0.489	0.194	6.364	0.012	0.613	0.419 ~ 0.897