2022 年第 4 期 第 17 卷

血清CC趋化因子配体和炎症因子对抑郁症患者自杀意念的影响

Effects of serum CC chemokine ligand and inflammatory factor levels on suicidal ideation in patients with depression

作者：韩克艳李宁乔君王朝敏王永良

英文作者：Han Keyan Li Ning Qiao Jun Wang Chaomin Wang Yongliang

单位：河北医科大学第一医院精神卫生科，石家庄050031

英文单位：Department of Mental Health the First Hospital of Hebei Medical University Shijiazhuang 050031 China

关键词：抑郁症；CC趋化因子配体2；CC趋化因子配体8；炎症因子；自杀意念

英文关键词：Depression;CCchemokineligand2;CCchemokineligand8;Inflammatoryfactors;Suicidalideation

• 摘要：

• 目的 探讨血清CC趋化因子配体2（CCL2）、CCL8和炎症因子对抑郁症患者自杀意念的影响。方法 选取2017年8月至2020年8月河北医科大学第一医院收治的抑郁症患者154例（抑郁症组），根据是否有自杀意念将患者分为自杀意念组（74例）和无自杀意念组（80例）,另选择同期于我院体检健康者71名为健康对照组。比较有无自杀意念组和健康对照组血清CCL2、CCL8和肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）和IL-1β水平，分析自杀意念组血清CCL2、CCL8水平与炎症因子表达的相关性。比较有无自杀意念组的一般临床资料，分析抑郁症患者产生自杀意念的影响因素。结果 自杀意念组和无自杀意念组血清CCL2、CCL8、TNF-α、IL-6、IL-1β水平均高于健康对照组，且自杀意念组均高于无自杀意念组［(1 022±326)ng/L比（623±169）ng/L、(90±25)ng/L比（71±18）ng/L、(9.2±3.2)μg/L比（6.2±2.0）μg/L、(96±30)ng/L比（72±19）ng/L、(87±16)ng/L比（43±12）ng/L］（均P＜0.05）。自杀意念组患者血清CCL2和CCL8水平与TNF-α、IL-6、IL-1β水平均呈正相关（均P＜0.001）。自杀意念组抑郁症病程长于无自杀意念组，自杀未遂史、睡眠质量差、合并慢性疾病比例，17项汉密尔顿抑郁量表（HAMD-17）评分，最近1周和最抑郁时的Beck自杀意念量表中文版（BSI-CV）总分、自杀意念强度评分、自杀危险性评分均高于无自杀意念组（均P＜0.05）。CCL2、CCL8、TNF-α、抑郁症病程、睡眠质量、HAMD-17评分、最抑郁时BSI-CV总分为抑郁症患者产生自杀意念的影响因素（均P＜0.05）。结论 抑郁症患者血清CCL2、CCL8和炎症因子水平均升高，CCL2、CCL8和TNF-α为抑郁症患者自杀意念产生的影响因素，CCL2、CCL8可能通过诱导神经炎症反应参与抑郁症患者自杀意念的产生过程。

• Objective To investigate the effects of serum CC chemokine ligand 2 (CCL2), CCL8 and inflammatory factors on suicidal ideation in patients with depression. Methods From August 2017 to August 2020, 154 patients with depression (depression group) admitted to the First Hospital of Hebei Medical University were selected. According to whether they had suicidal ideation, the patients were divided into suicidal ideation group (74 cases) and non suicidal ideation group (80 cases). Seventy-one healthy people who underwent physical examination in the hospital were selected as the healthy control group. The levels of serum CCL2, CCL8, tumor necrosis factor-α（TNF-α）, interleukins-6 (IL-6) and IL-1β were compared among groups with or without suicidal ideation and healthy control group. The relationship of serum CCL2 and CCL8 with inflammatory factors in suicidal ideation group was analyzed. The general clinical data were compared between groups with or without suicidal ideation, and the influencing factors of suicidal ideation in patients with depression were analyzed. Results Serum levels of CCL2, CCL8, TNF-α, IL-6 and IL-1β in suicidal ideation group and non suicidal ideation group were higher than those in healthy control group, and those in suicidal ideation group were higher than those in non suicidal ideation group［(1 022±326)ng/L vs (623±169)ng/L, (90±25)ng/L vs (71±18)ng/L, (9.2±3.2)μg/L vs (6.2±2.0)μg/L, (96±30)ng/L vs (72±19)ng/L, (87±16)ng/L vs (43±12)ng/L］(all P<0.05). Levels of serum CCL2 and CCL8 were positively correlated with TNF-α, IL-6 and IL-1β in suicidal ideation group(all P<0.001). The duration of depression in suicidal ideation group was longer than that in the non suicidal ideation group, proportions of attempted suicide history, poor sleep quality and complicated with chronic diseases in suicidal ideation group were higher than those in non suicidal ideation group, the score of 17 items of Hamilton Depression Scale (HAMD-17), the total score of Beck suicidal ideation scale Chinese version (BSI-CV) last 1 week and when most depressed, the score of suicidal ideation intensity, and the score of suicide risk in suicidal ideation group were higher than those in non suicidal ideation group (all P<0.05). CCL2, CCL8, TNF-α, the course of depression, sleep quality, HAMD-17 score and the total score of BSI-CV when most depressed were the influencing factors of suicidal ideation in patients with depression (all P<0.05). Conclusions The levels of serum CCL2, CCL8 and inflammatory factors are increased in patients with depression. CCL2, CCL8 and TNF-α are influencing factors of suicidal ideation in patients with depression. CCL2 and CCL8 may participate in the process of suicidal ideation in patients with depression by inducing neuroinflammatory response.