| 唐翼,任建宇,黄花.血清白细胞介素 -6、瘦素、 5-羟色胺水平与冠状动脉性心脏病继发抑郁的关系及联合预测价值分析[J].安徽医药,2025,29(12):2399-2403. |
| 血清白细胞介素 -6、瘦素、 5-羟色胺水平与冠状动脉性心脏病继发抑郁的关系及联合预测价值分析 |
| Relationship between serum interleukin-6, leptin, 5-hydroxytryptamine levels and depression secondary to coronary heart disease and their combined predictive value |
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| DOI：10.3969/j.issn.1009-6469.2025.12.014 |
| 中文关键词: 冠状动脉性心脏病 抑郁 白细胞介素 -6 瘦素 5-羟色胺 预测 |
| 英文关键词: Coronary heart disease Depression Interleukin-6 Leptin 5-hydroxytryptamine Forecast |
| 基金项目:四川省医学(青年创新)科研项目( S211130) |
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| 中文摘要: |
| 目的分析血清白细胞介素 -6(IL-6)、瘦素、 5-羟色胺( 5-HT)水平与冠状动脉性心脏病( CHD)继发抑郁的关系及联合预测价值。方法前瞻性选取 2022年 1月至 2023年 1月四川省南充精神卫生中心住院治疗的 CHD病人 195例，统计治疗后 6个月内继发抑郁情况，据此分为抑郁组和非抑郁组，比较两组入院时一般资料、治疗后 1周血清 IL-6、瘦素、 5-HT水平，分析 CHD病人治疗后继发抑郁的影响因素，并分析治疗后 1周血清 IL-6、瘦素、 5-HT水平预测 CHD病人治疗后继发抑郁的价值，将常规影响因素联合作为常规预测模型，在常规预测模型基础上联合血清治疗后 1周 IL-6、瘦素、 5-HT水平作为新预测模型，比较两种预测模型的预测价值。结果进入结果分析的 190例 CHD病人中，治疗后 6个月内抑郁发生率为 26.84%(51/190)；抑郁组女性占比、病程、心功能分级 ≥Ⅲ级占比、血清 IL-6水平［( 10.35±3.15)ng/L比( 7.31±2.08)ng/L］高于非抑郁组，受教育程度高中及以上占比、婚姻状况正常占比、血清瘦素水平［( 8.29±2.23)μg/L比( 12.41±2.65)μg/L］、 5-HT水平［( 297.86±71.52)ng/L比(354.09±84.31)ng/L］低于非抑郁组(P<0.05)；性别、病程、受教育程度、婚姻状况、心功能分级、治疗后 1周血清 IL-6、瘦素、 5-HT均为 CHD病人治疗后继发抑郁的影响因素( P<0.05)；治疗后 1周血清 IL-6、瘦素、 5-HT水平预测 CHD病人治疗后继发抑郁的曲线下面积(AUC)分别为 0.73、0.74、0.75；新预测模型预测 CHD病人治疗后继发抑郁的 AUC为 0.94，95%CI:(0.90，0.97)，预测灵敏度为 86.27%，特异度为 88.49%，与常规预测模型比较，新预测模型的 AUC明显增大，净重新分类指数( NRI)、综合判别改善指数( IDI)均 >0(P<0.05)。结论血清 IL-6、瘦素、 5-HT水平是 CHD病人治疗后继发抑郁的影响因素，具有预测继发抑郁的价值，特别是与常规影响因素联合能明显提高预测效能。 |
| 英文摘要: |
| Objective To analyze the relationship between serum interleukin-6 (IL-6), leptin, 5-hydroxytryptamine (5-HT) levels and depression secondary to coronary heart disease (CHD) and their combined predictive value.Methods A total of 195 CHD patientswho were hospitalized in Nanchong Mental Health Center of Sichuan Province from January 2022 to January 2023 were prospectivelyselected. The incidence of secondary depression within 6 months after treatment was statistically analyzed, and patients were according-ly divided into a depression group and a non-depression group. The general data at admission, and the levels of serum IL-6, leptin, and 5-HT one week after treatment were compared between the two groups, and the influencing factors for secondary depression in CHD pa-tients after treatment were analyzed. The value of predicting secondary depression was analyzed in CHD patients after treatment by ana-lyzing the levels of serum IL-6, leptin, and 5-HT one week after treatment. The routine influencing factors were combined as a routineprediction model, and the routine prediction model was combined with the levels of serum IL-6, leptin, and 5-HT one week after treat-ment as a new prediction model. The predictive values of the two prediction models were compared.Results Among the 190 CHD pa-tients included in the outcome analysis, the incidence of depression within 6 months after treatment was 26.84% (51/190). The propor-tion of female, course of disease, proportion of patients with cardiac function grade ≥ Ⅲ and serum IL-6 level [(10.35±3.15) ng/L vs. (7.31±2.08) ng/L] in the depression group were higher than those in the non-depression group. The proportions of patients with educa-tion level of senior middle school and above, and those with normal marital status, and levels of serum leptin [(8.29±2.23) μg/L vs. (12.41±2.65) μg/L], and 5-HT [(297.86±71.52) ng/L vs. (354.09±84.31) ng/L] were lower in depression group than in non-depression group (P<0.05). Gender, course of disease, education level, marital status, cardiac function classification, serum IL-6, leptin and 5-HT at 1 week after treatment were all influencing factors for secondary depression in CHD patients after treatment (P<0.05). The areas un-der the curve (AUC) of serum IL-6, leptin and 5-HT levels at 1 week after treatment for predicting secondary depression in CHD pa-tients after treatment were 0.73, 0.74, and 0.75, respectively. The AUC of the new prediction model was 0.94, 95%CI: (0.90, 0.97), thepredictive sensitivity was 86.27%, and the specificity was 88.49%. Compared with the conventional prediction model, the AUC of thenew prediction model was significantly increased, and the net reclassification index (NRI) and the integrated discrimination improve-ment (IDI) were > 0 (P<0.05).Conclusion Serum IL-6, leptin, and 5-HT are factors that affect the development of secondary depres-sion in CHD patients after treatment, which have predictive value for secondary depression, and especially when combined with conven-tional factors, they can significantly improve the predictive efficacy. |
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