| 施于超,胡卫红,白 丽,何 方,陆光华.血清ghrelin、NLRP3对老年抑郁症患者认知功能损害的诊断价值分析[J].,2023,(13):2460-2465 |
| 血清ghrelin、NLRP3对老年抑郁症患者认知功能损害的诊断价值分析 |
| Diagnostic Value of Serum Ghrelin and NLRP3 in Cognitive Impairment of Elderly Patients with Depression |
| 投稿时间：2023-01-28 修订日期：2023-02-23 |
| DOI：10.13241/j.cnki.pmb.2023.13.012 |
| 中文关键词: Ghrelin NLRP3 老年 抑郁症 认知功能 诊断价值 |
| 英文关键词: Ghrelin NLRP3 Elderly Depression Cognitive function Diagnostic value |
| 基金项目:上海市卫生和计划生育委员会科研项目（2018-641） |
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| 中文摘要: |
| 摘要 目的：分析血清胃促生长素（ghrelin）、Nod样受体热蛋白结构域相关蛋白3（NLRP3）对老年抑郁症患者认知功能损害的诊断价值。方法：选择2020年1月至2021年10月在我院接受诊治的老年抑郁症患者90例作为抑郁症组，另选取同期精神健康老年志愿者50例作为对照组。根据抑郁症病情严重程度将老年抑郁症患者分为轻度组（n=32）、中度组（n=30）、重度组（n=28），比较不同分组研究对象血清ghrelin、NLRP3水平变化。另根据老年抑郁症患者是否发生认知功能损害分为认知功能损害组和认知功能未损害组，收集患者一般人口学及临床资料，分析影响老年抑郁症患者认知功能发生损害的危险因素。采用受试者工作特征（ROC）曲线分析血清ghrelin、NLRP3对老年抑郁症患者认知功能损害的诊断价值。结果：重度组血清NLRP3炎症小体水平明显高于中度组，中度组血清NLRP3炎症小体水平明显高于轻度组，轻度组血清NLRP3炎症小体水平明显高于对照组（P<0.05）；重度组血清ghrelin水平明显低于中度组，中度组血清ghrelin水平明显低于轻度组，轻度组血清ghrelin水平明显低于对照组（P<0.05）。多因素Logistic回归分析结果显示，重大生活事件（意外事故、破产、至亲去世等）、合并糖尿病、血清ghrelin水平、独居、血清NLRP3炎症小体水平以及社会支持是老年抑郁症患者认知功能损害的影响因素（P<0.05）。血清NLRP3炎症小体、ghrelin单独以及联合诊断老年抑郁症患者认知功能损害的曲线下面积AUC（0.95CI）分别为0.723（0.506～0.922）、0.782（0.619～0.917）、0.863（0.721～0.981）。结论：血清NLRP3炎症小体水平在老年抑郁症患者中呈高表达、ghrelin水平呈现低表达，二者均是老年抑郁症患者认知功能损害的影响因素，且联合检测二者水平可辅助诊断老年抑郁症患者认知功能损害。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the diagnostic value of serum ghrelin, Nod like receptor heat protein domain related protein 3 (NLRP3) for cognitive impairment in elderly patients with depression. Methods: A total of 90 elderly depressed patients disorder who were diagnosed in our hospital from January 2020 to October 2021 were selected as the depression group, while another 50 mentally healthy elderly volunteers during the same period were selected as the control group. According to the severity of depressive illness, elderly depressed patients were divided into mild group (n=32), moderate group (n=30), and severe group (n=28), and the serum levels of ghrelin and NLRP3 were compared. In addition, the elderly depressed patients were divided into cognitive impairment group and cognitive non impairment group, and general demographic and clinical data of the patients were collected to analyze the risk factors affecting the occurrence of impairment of cognitive function in elderly patients with depression. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of serum ghrelin and NLRP3 for cognitive impairment in elderly patients with depression. Results: The levels of serum NLRP3 inflammasome in the severe group were significantly higher than theat in the moderate group, the levels of serum NLRP3 inflammasome in the moderate group were significantly higher than that the mild group, and the levels of serum NLRP3 inflammasome in the mild group were significantly higher than taht the control group(P<0.05); The levels of serum ghrelin in the severe group were significantly lower than that the moderate group, the levels of serum ghrelin in the moderate group were significantly lower than that the mild group, and the levels of serum ghrelin in the mild group were significantly lower than that the control group (P<0.05). Multiple logistic regression analysis revealed that major life events(accidents, bankruptcy, death to first relatives,etc.), comorbid diabetes, serum ghrelin levels, living alone, serum NLRP3 inflammasome levels, and social support were significant influencing factors of cognitive impairment in elderly patients with depression(P<0.05). The area under the curve AUC(0.95 CI) of serum NLRP3 inflammasome, ghrelin alone and in combination for the diagnosis of cognitive impairment in elderly patients with depression were 0.723 (0.506-0.922), 0.782 (0.619-0.917), 0.863(0.721-0.981, respectively. Conclusion: Serum levels of the NLRP3 inflammasome is highly expressed and ghrelin is low in elderly patients with depression, which is more significant with the aggravation of the patient's condition. Both are contributing factors to cognitive impairment in older depressed patients, Moreover, the combined detection of both levels may assist in the diagnosis of cognitive impairment in elderly patients with depression. |
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