摘要
目的探索双相情感障碍不同心境状态与免疫及应激因子的相关性,为探索不同心境状态的潜在病理生理机制提供线索。方法回顾性选取2018年1—12月在首都医科大学附属北京安定医院住院的1989例双相情感障碍患者作为研究对象,其中双相躁狂发作患者1182例,双相抑郁发作患者536例,双相混合发作患者271例。对3种不同发作类型患者的人口学资料及生化指标进行比较,生化指标包括C反应蛋白(CRP)、补体3(C3)、补体4(C4)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、促肾上腺皮质激素(ACTH)及皮质醇。应用多元Logistic回归分析控制混杂因素,明确各生化指标对双相情感障碍不同心境状态的影响。结果双相躁狂发作、双相抑郁发作及双相混合发作患者的年龄、CRP、C3、C4、IgM、IgA、ACTH比较,差异有统计学意义(P<0.05)。与双相抑郁发作相比,IgA(OR=1.220,95%CI=1.094~1.360)、C4(OR=7.281,95%CI=1.203~44.067)及ACTH(OR=0.996,95%CI=0.994~0.998)是双相躁狂发作的影响因素(P<0.05);C3(OR=0.246,95%CI=0.115~0.523)、ACTH(OR=0.996,95%CI=0.993~0.999)是双相混合发作的影响因素(P<0.05)。结论在双相情感障碍不同心境状态的患者中,炎症及应激因子的水平存在差异。双相混合发作患者与较低C3水平相关,双相抑郁发作与较高ACTH水平相关,双相躁狂发作患者与较高IgA水平相关。
Objective To explore the correlation between different mood states and immune and stress factors in bipolar disorder,so as to provide clues for exploring the potential pathophysiological mechanism of different mood states.Methods This study is a retrospective study.A total of 1989 patients with bipolar disorder hospitalized in Beijing Anding Hospital Affiliated to Capital Medical University from January to December 2018 were selected as the research objects.Among them,there were 1182 patients in manic phase,536 patients in depressive phase and 271 patients in mixed phase.Demographic data and biochemical indicators were compared among three different mood state groups.The biochemical indicators included C-reactive protein(CRP),complement 3(C3),complement 4(C4),immunoglobulin M(IgM),immunoglobulin G(IgG),immunoglobulin A(IgA),adrenocorticotropic hormone(ACTH)and cortisol.Multiple Logistic regression analyses were performed to analyze the control confounding factors,and clarify the effects of biochemical indexes on different mood states of bipolar disorder.Results The differences in age,CRP,C3,C4,IgM,IgA,ACTH were statistically significant among the three groups(P<0.05).Comparing with bipolar depressive group,IgA(OR=1.220,95%CI=1.094-1.360),C4(OR=7.281,95%CI=1.203-44.067)and ACTH(OR=0.996,95%CI=0.994-0.998)were the influencing factors to the bipolar manic group(P<0.05).C3(OR=0.246,95%CI=0.115-0.523),ACTH(OR=0.996,95%CI=0.993-0.999)were the influencing factors to the mixed group(P<0.05).Conclusions There are differences in levels of inflammatory and stress factors in patients with bipolar disorder in different mood states.Patients with mixed biphasic episodes were associated with lower C3 levels,bipolar depressive episodes were associated with higher ACTH levels,and bipolar manic episodes were associated with higher IgA levels.
作者
赵茜
杨元
吕楠
付冰冰
张玲
Zhao Qian;Yang Yuan;Lyu Nan;Fu Bingbing;Zhang Ling(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;The Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China)
出处
《神经疾病与精神卫生》
2022年第5期357-362,共6页
Journal of Neuroscience and Mental Health
基金
北京市医院管理中心临床医学发展专项“扬帆”计划临床技术创新项目(XMLX202128)。
