【摘要】

目的：研究双相情感障碍（BD）、单相抑郁（UD）、健康人群中促炎细胞因子可溶性白细胞介素-6受体(sIL-6R)，1型可溶性肿瘤坏死因子受体(sTNF-R1)和单核细胞趋化蛋白-1（MCP-1）水平差异，探讨BD、UD的炎症机制。
方法：以初治BD、UD患者和正常对照（NC）人群为研究对象，ELISA检测三组人群外周静脉血中的sIL-6R，sTNF-R1，MCP-1浓度，去除MADRS评分、YMRS评分、吸烟、合并症和BMI混杂因素影响，多元回归分析BD、UD患者中三种炎症因子的水平差异。
结果：共纳入了30例BD，35例UD和30例NC。BD组合并症比例、吸烟比例、BMI均高于UD组（p = 0.033，0.012，0.040＜0.05）。BD组外周血中sIL-6R，sTNF-R1，MCP-1浓度均高于UD组（p=0.021，0.023，0.035<0.05）。具有合并症患者具有更高的sIL-6R、sTNF-R1和MCP-1水平（p =0.002,0.001,0.001<0.05）；BMI≥25组sIL-6R、sTNF-R1 和MCP-1较BMI＜25高（p=0.031,0.026,0.030＜0.05）。去除混杂因素，多元回归分析
结果表明：sIL-6R、sTNF-R1、MCP-1在 BD组和UD组差异有统计学意义（BD＞UD，p=0.002，0.006，0.012<0.05）。
结论：BD组sIL-6R，sTNF-R1和MCP-1水平较UD组高。这表明BD中可能存在更严重的炎症失调。

【Abstract】

Objective: To investigate the level differences of pro-inflammatory cytokines including soluble interleukin-6 receptor (SIL-6R), soluble tumor necrosis factor receptor type 1 (sTNF-R1), monocyte chemotactic protein-1(MCP-1) among bipolar disorder (BD),unipolar depression (UD) and normal controls (NC) groups;.To explore the inflammatory mechanism.in BD and UD.
Methods: Study subjects were BD or UD and normal controls (NC). Pro-inflammatory cytokines, including sIL-6R,sTNF-R1),MCP-1 were assessed in all subjects by enzyme-linked immunosorbent assays(ELISA). The multiple variant regression model was used to compare pro-inflammatory cytokines between BD and UD,while controlling for the confounding factors including MADRS scores,YMRS scores, smoking, medical comorbidity, and body mass index(BMI).
Results: In all, 30 patients with BD, 35 patients with UD, and 130 NC were enrolled in the study. The BD group had significantly higher smoking rate, more medical comorbidity, higher BMI than the UD groups（p=0.033,0.012,0.040,all＜0.05）.The levels of sIL-6R, sTNF-R1, and MCP-1 in BD group were significantly higher than the UD group（p=0.021,0.023,0.035,all<0.05）. Patients with comorbidities had higher levels of sIL-6R, sTNF-R1 and MCP-1（p =0.002,0.001,0.001,all<0.05）. The levels of sIL-6R, sTNF-R1 and MCP-1 in BMI≥25 group were higher than BMI <25 group（p=0.031,0.026,0.030,all＜0.05）.Controlling for MADRS scores,YMRS scores, smoking, medical comorbidity, and BMI in the regression model,the results showed that the BD group had significantly higher levels of sIL-6R (p=0.002), sTNF-R1 (p = 0.006), and MCP-1(p = 0.012) than the UD group.
Conclusion  s: Higher levels of sIL-6R, sTNF-R1, and MCP-1 were found in BD than in UD. These results may suggest a more severe inflammatory dysregulation in BD.