收稿日期: 2023-11-28
网络出版日期: 2024-06-14
基金资助
甘肃省科技计划项目(21JR1RA125)
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。
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 . DOI: 10.3969/j.issn.1006-5725.2024.12.011
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（Zcombined detection - claudin-5 = 2.393， Zcombined 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
| 1 | 王露， 王鑫， 张婷，等. 收肌管阻滞联合静脉自控镇痛对全膝关节置换术患者术后抑郁状态的影响 ［J］. 实用医学杂志， 2023， 39（6）： 696-700. doi:10.3969/j.issn.1006-5725.2023.06.007 |
| 2 | ALOZAIRI E， OZAIRI A A， Blythe C， et al. The epidemiology of depression and diabetes distress in Type 2 diabetes in kuwait［J］. J Diabetes Res， 2020，2020：7414050. doi:10.1155/2020/7414050 |
| 3 | 徐蕊，黄兴兵. 难治性抑郁症非药物治疗新进展［J］. 实用医学杂志， 2024， 40（4）： 439-446. |
| 4 | HU C S， CHEN G S， TU H P. Epidemiology of Depression in Patients with Psoriasis：A Nationwide Population-based Cross-sectional Study［J］. Acta Derm Venereol， 2019， 99（6）：530-538. doi:10.2340/00015555-3145 |
| 5 | GANAPATHY A S， SAHA K， SUCHANEC E， et al. AP2M1 mediates autophagy-induced CLDN2 （claudin 2） degradation through endocytosis and interaction with LC3 and reduces intestinal epithelial tight junction permeability［J］. Autophagy， 2022， 18（9）：2086-2103. doi:10.1080/15548627.2021.2016233 |
| 6 | KAKOGIANNOS N， FERRARI L， GIAMPIETRO C， et al. JAM-A Acts via C/EBP-α to Promote Claudin-5 expression and enhance endothelial barrier function［J］. Circ Res， 2020， 127（8）：1056-1073. doi:10.1161/circresaha.120.316742 |
| 7 | YANG Z， LIN P， CHEN B， et al. Autophagy alleviates hypoxia-induced blood-brain barrier injury via regulation of CLDN5 （claudin 5）［J］. Autophagy，2021， 17（10）：3048-3067. doi:10.1080/15548627.2020.1851897 |
| 8 | DUAN J， CUI J， YANG Z， et al. Neuroprotective effect of Apelin 13 on ischemic stroke by activating AMPK/GSK-3β/Nrf2 signaling［J］. J Neuroinflammation， 2019， 16（1）：24-25. doi:10.1186/s12974-019-1406-7 |
| 9 | MOSTERT C B， SINGH R D， GERRITSEN M， et al. Long-term outcome after severe traumatic brain injury ： a systematic literature review［J］. Acta Neurochir（Wien）， 2022， 164（3）：599-613. doi:10.1007/s00701-021-05086-6 |
| 10 | CHEN Q， SHEN W， SUN H， et al. Effects of Mirror therapy on motor aphasia after acute cerebral infarction：A randomized controlled trial［J］. Neuro Rehabilitation， 2021， 49（1）：103-117. doi:10.3233/nre-210125 |
| 11 | YAN W， FAN J， ZHANG X， et al. Decreased neuronal synaptosome associated protein 29 contributes to post stroke cognitive impairment by disrupting presynaptic maintenance［J］. Theranostics， 2021， 11（10）：4616-4636. doi:10.7150/thno.54210 |
| 12 | 中华医学会精神科分会. CCMD-3中国精神障碍分类与诊断标准［M］. 3版.济南：山东科学技术出版社， 2001：7-8. |
| 13 | LIN C H， PARK C， MCINTYRE R S. Early improvement in HAMD-17 and HAMD-7 scores predict response and remission in depressed patients treated with fluoxetine or electroconvulsive therapy［J］. J Affect Disord， 2019， 253（1）：154-161. doi:10.1016/j.jad.2019.04.082 |
| 14 | WORLD HEALTH ORGANIZATION. International statistical classification of diseases and related health problems， tenth revision （ICD-10）［M］. Geneva：World Health Organization， 1994：1-4. |
| 15 | PAN Z， PARK C， BRIETZKE E， et al. Cognitive impairment in major depressive disorder［J］. CNS Spectr， 2019， 24（1）：22-29. doi:10.1017/s1092852918001207 |
| 16 | 谭秋晓， 张红梅， 李洁明， 等. 多囊卵巢综合征患者抑郁和焦虑发病现状及影响因素分析［J］. 实用医学杂志， 2020， 36（23）：3288-3292. doi:10.3969/j.issn.1006-5725.2020.23.025 |
| 17 | LU X， YANG D， LIANG J， et al. Effectiveness of intervention program on the change of glycaemic control in diabetes with depression patients： A meta-analysis of randomized controlled studies［J］. Prim Care Diabetes， 2021， 15（3）：428-434. doi:10.1016/j.pcd.2021.01.006 |
| 18 | LIU L， WANG H， CHEN X， et al. Gut microbiota and its metabolites in depression： from pathogenesis to treatment［J］. E Bio Medicine， 2023， 90（1）：527-528. doi:10.1016/j.ebiom.2023.104527 |
| 19 | SIMO S M， SIELA D. Use of a depression and sleep impairment treatment guideline to improve quality of life for patients with sickle cell disease［J］. Int J Palliat Nurs， 2018， 24（1）：246-255. doi:10.12968/ijpn.2018.24.5.246 |
| 20 | PEARSON O， UGLIK M N， MISKOWIAK K W， et al. The relationship between sleep disturbance and cognitive impairment in mood disorders： A systematic review［J］. J Affect Disord， 2023， 327（1）：207-216. doi:10.1016/j.jad.2023.01.114 |
| 21 | HARUWAKA K， IKEGAMI A， TACHIBANA Y， et al. Dual microglia effects on blood brain barrier permeability induced by systemic inflammation［J］. Nat Commun， 2019， 10（1）：5816-5817. doi:10.1038/s41467-019-13812-z |
| 22 | CHEN R F， CAI Y， ZHU Z H， et al. Sleep disorder as a clinical risk factor of major depression： associated with cognitive impairment［J］. Asian J Psychiatr， 2022， 76（1）：228-229. doi:10.1016/j.ajp.2022.103228 |
| 23 | FRANZEN P L， BUYSSE D J. Sleep disturbances and depression： risk relationships for subsequent depression and therapeutic implications［J］. Dialogues Clin Neurosci， 2008，10（4）：473-481. doi:10.31887/dcns.2008.10.4/plfranzen |
| 24 | SUN Z W， WANG X， ZHAO Y， et al. Blood-brain barrier dysfunction mediated by the EZH2-Claudin-5 axis drives stress-induced TNF-α infiltration and depression-like behaviors［J］. Brain Behav Immun， 2024， 115（1）：143-156. doi:10.1016/j.bbi.2023.10.010 |
| 25 | WANG X， TIAN X， PEI L L， et al. The association between serum apelin-13 and the prognosis of acute ischemic stroke［J］. Transl Stroke Res， 2020， 11（4）：700-707. doi:10.1007/s12975-019-00769-w |
| 26 | 李志良， 李来兴， 刘启瑞. 血清Apelin-13联合Rotterdam-CT评分对颅脑损伤患者病情及预后的评估价值［J］. 河北医学， 2023， 29（1）：120-126. doi:10.3969/j.issn.1006-6233.2023.01.023 |
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