广西医学

目的探讨抑郁症患者血清炎症因子、糖脂代谢指标、miR⁃155及脑源性神经营养因子（BDNF）表达水平与其认知功能的关系。方法选取240例抑郁症患者作为研究对象，根据24项汉密尔顿抑郁（HAMD⁃24）量表的评分结果，将其分为轻度抑郁组、中度抑郁组、重度抑郁组，每组80例。比较3组患者的蒙特利尔认知评估（MoCA）量表得分，血清炎症因子［白细胞介素（IL）⁃1β、IL⁃6、肿瘤坏死因子α（TNF⁃α）］及BDNF水平，总胆固醇、三酰甘油、HDL、LDL水平，以及空腹血糖水平和血清miR⁃155表达水平。采用Pearson相关分析评估血清miR⁃155表达水平与相关指标的相关性，采用非条件Logistic回归模型分析抑郁症患者发生认知功能障碍的影响因素。结果轻度抑郁组、中度抑郁组、重度抑郁组患者的血清IL⁃6水平、TNF⁃α水平、miR⁃155表达水平依次升高（P <0.05），MoCA量表总分、视空间与执行能力得分、语言得分、注意力得分、抽象思维得分、延迟记忆得分，以及HDL水平和血清BDNF水平依次降低（P <0.05）。抑郁症患者的血清miR⁃155表达水平与HAMD⁃24量表总分、空腹血糖水平、血清TNF⁃α水平呈正相关，与MoCA量表总分、MoCA量表视空间与执行能力得分、HDL水平、血清BDNF水平呈负相关（P <0.05）。非条件Logistic回归分析结果显示，HAMD⁃24量表总分、血清TNF⁃α水平、血清miR⁃155表达水平升高是抑郁症患者发生认知功能障碍的危险因素（P <0.05）。结论血清TNF⁃α水平、miR⁃155表达水平升高是抑郁症患者发生认知功能障碍的独立危险因素，血清炎症因子水平增高，以及血清BDNF和HDL水平降低与抑郁症患者发生认知功能障碍关系密切。

Objective To investigate the correlation of serum inflammatory factors, glucose and lipid metabolism indices, miR⁃155 and brain⁃derived neurotrophic factor (BDNF) expressions with cognitive function in patients with depression. Methods A total of 240 patients with depression were selected as the research subjects, and they were assigned to mild depression group, moderate depression group or severe depression group according to their score results of Hamilton Depression 24 (HAMD⁃24) scale, with 80 cases in each group. The scale score of Montreal Cognitive Assessment (MoCA), serum inflammatory factors (interleukin ［IL］⁃1β, IL⁃6, tumor necrosis factor α ［TNF⁃α］) and BDNF levels, as well as levels of total cholesterol, triglyceride, HDL, LDL, and fasting blood glucose level and serum miR⁃155 expression were compared between patients of the three groups. The Pearson correlation analysis was used to evaluate the correlation of serum miR⁃155 expression with relevant incices, and the unconditional Logistic regression model was employed to analyze the influencing factors for depression patients suffering from cognitive dysfunction. Results Serum IL⁃6 and TNF⁃α levels, and serum miR⁃155 expression were elevated successively in the mild depression, moderate depression, and severe depression groups (P<0.05), whereas total score, and visual space and executive ability, language, attention, abstract thinking, delayed memory scores of MoCA scale, and HDL level and serum BDNF level were decreased successively in the mild depression, moderate depression, and severe depression groups (P<0.05). Serum miR⁃155 expression positively correlated with HAMD⁃24 scale total score, fasting blood glucose level, and serum TNF⁃α level in patients with depression, whereas negatively correlated with total score of MoCA scale, visual space and executive ability score of MoCA scale, HDL level, and serum BDNF level (P<0.05). The results of unconditional Logistic regression analysis revealed that the elevations of total score of HAMD⁃24 scale, serum TNF⁃α level, serum miR⁃155 expression were the risk factors for the occurrence of cognitive dysfunction in patients with depression (P<0.05). Conclusion The elevations of serum TNF⁃α level and miR⁃155 expression are the independent risk factors for the occurrence of cognitive dysfunction in patients with depression. The elevations of serum inflammatory factors levels, and decreases of serum BDNF and HDL levels are closely related to patients with depression suffering from cognitive dysfunction.