Higher Depressive Symptoms are Associated with Systemic Inflammation in Stable Hemodialysis Patients

血液透析病患全身性發炎狀態與憂鬱程度之相關

邱彥霖(Yen-Ling Chiu) ； 莊宜芳(Yi-Fang Chuang) ； 方凱企(Kai-Chi Fang) ； 劉絮愷(Shih-Kai Liu) ； 陳泓源(Hung-Yuan Chen) ； 徐世平(Shih-Ping Hsu) ； 白玫芬(Mei-Fen Pai) ； 賴俊夫(Chung-Fu Lai) ； 彭渝森(Yu-Sen Peng)

《Acta Nephrologica》 22卷3期 (2008/09) Pp. 185-190

摘要

背景：血液透析患者有較高的全身性發炎狀態及較高的憂鬱程度，且兩者皆可獨立預測血液透析息者的存活率。本研究旨在研究兩者的相關性。
研究方法：本研究包含一百二十五位穩定的慢性血液透析患者。患者的憂鬱程度使用中文版貝克憂鬱量表測量。使用血液中C-反應蛋白(C-reactive protein)的值及細胞激素濃度(interleukin-lβ, interleukin-6 and tumor necrosis factor-α)代表發炎狀態的程度。
研究結果：血液中C-反應蛋白值與憂鬱狀態呈顯著正相關(β=0.190, p=0.018)。憂鬱量表得分較低（小於15）的患者，血液中C-反應蛋白值也顯著較低(2.60mg/L versus 4.21mg/L, p=0.013)。血液中細胞激素值與憂鬱程度呈現正相關但均未達統計顯著水準。
結論：血液透析患者的憂鬱程度與全身性發炎程度有關。

關鍵字

發炎狀態 ； 憂鬱 ； 營養不良 ； 血液透析

並列摘要

Background: Depression is linked to immune dysfunction in patients without renal disease. In end-stage renal disease (ESRD) patients, both depression and systemic inflammation are linked to cardiovascular mortality. However, the relationship between depressive symptoms and serum pro-inflammatory cytokine levels in ESRD has not been studied before.
Methods: A total of 125 individuals who had received regular hemodialysis for at least three months participated in this study. Severity of depression was measured by the Beck Depression Index (BDI). Patients were divided into two groups according to BDI scores. (Group 1:BDI＜15, Group 2:BDI≥15)
Results: Compared with Group 1, Group 2 patients had significantly higher serum levels of high-sensitivity C reactive protein (Group 1 (2.60 mg/L) versus Group 2 (4.21 mg/L), P=0.013). Group 2 patients tended to have higher serum levels of interleukin-lβ, interleukin-6 and tumor necrosis factor-α levels. In all patients, the BDI scores were correlated significantly with hsCRP levels (β=0.190, p=0.018). All serum pro-inflammatory cytokine levels also correlated positively with the BDI scores, although none of them reached statistical significance.
Conclusion: Higher systemic inflammatory status is observed in stable hemodialysis patients with higher BDI scores. Systemic inflammation might be the link between depression and cardiovascular mortality in hemodialysis patients.

並列關鍵字

Inflammation ； depression ； malnutrition ； hemodialysis