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IL-6, IL-2 and HRV depression in the elderly and significance of the changes

Author: WangTao
Tutor: LuYanRu
School: Zhengzhou University
Course: Geriatrics
Keywords: Depression in the elderly Cytokines Interleukin HRV
CLC: R749.4
Type: Master's thesis
Year: 2010
Downloads: 104
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Abstract

Depression is a common psychological, mental disorders, each year about 15% of the population prevalence, China has about 26 million. World Health Organization (WHO) in the \China is the world's largest developing country, the most populous, with aging countries into the ranks of the elderly as a special group in our society, more prominent depression in the elderly, has become second only to the more common dementia mental disorders, is increasingly being valued by the people. In recent years, cytokines and depression in the elderly is closely related to the occurrence and development of resistance and depression in the elderly caused by HRV (heart rate variability HRV) changes, then induced, increased coronary heart disease has been increasingly valued by clinicians. Many studies have found that foreign cytokines can cause depression, and depression can also cause changes in cytokines and HRV, then induced, increased cardiovascular disease, and the prognosis of the disease impact that depression is cardiovascular disease, development and affect the prognosis an independent risk factor. Depression in the elderly and the interaction between cytokines and HRV mechanism so far there is not a perfect theory articulated. Existing theories shows coronary endothelial damage is a kind of chronic inflammatory response, and is accompanied by depression, inflammatory immune responses. This paper by measuring elderly depressed patients immune inflammatory cytokines interleukin -6 (IL-6), interleukin -2 (IL-2) levels and 24-hour ambulatory electrocardiogram (DCG) heart rate variability (HRV) changes in elderly depression and cytokines and the link between cardiac autonomic nervous to explore the mechanisms by which, for clinical work with some new ideas. Subjects and Methods 1. Study depression group (experimental group) collected from August 2008 to October 2009 period in Zheng freshman Affiliated elderly inpatients 31 cases. Inclusion criteria: ① meet China Classification and diagnostic manual of mental disorders (CCMD-3), mental health symptom checklist (SCL-90) 2-or factor score ≥ 3 points and Hamilton Depression Scale (HAMD) ≥ 2 级persons; ② aged ≥ 60 years, no history of alcohol and drug abuse. Exclusion criteria: ① organic disorder, or psychoactive substances and non-addictive substance-induced depression; ② multiple episodes, within the last year who have taken immunomodulatory agents, antidepressants, lithium salt; ③ received ECT persons; ④ past month colds, fever and other infectious diseases; ⑤ suffering from endocrine diseases, liver and other serious physical illness; ⑥ blood, liver function, kidney function and other laboratory tests obvious abnormalities; ⑦ illiterate. Including 15 males and 16 females, mean age (67.2 ± 5.6) years of age. Gender, age, no significant difference (P gt; 0.05). Control group and the depression group selected 28 cases of physical and mental health over the same period the patient's family and the normal elderly volunteers, requiring no family history of mental illness, alcohol and drug abuse history. Exclusions ① family tragedies such as the recent burst of negative events in patients; ② illiterate. Including 14 males and 14 females, mean age (66.8 ± 5.3) years of age. Compare two groups of gender, age, no significant difference (P gt; 0.05). These participants were informed consent to the study. 2 Methods Enzyme linked immunosorbent assay (ELISA) was measured 31 cases of elderly patients with depression before and after antidepressant treatment, 28 cases of non-mental disorder serum Workers L-6, IL-2 levels. Physiological recorder with three of the above 59 cases were older 24-hour ambulatory electrocardiogram (DCG) waveform record. The detection of 24-hour ambulatory electrocardiogram (DCG) for HRV (heart rate variability HRV) time domain and frequency domain analysis. 3 Statistical analysis All data were processed by SPSS13.0 statistical software, measurement data with x ± s said that for normality test, in line with the normal distribution by using groups t test, those who do not meet the normal distribution using the Wilcoxon test, test level = 0.05, P lt; 0.05 was considered statistically significant. Results 1. Depression group (experimental group) of IL-6, IL-2 levels were significantly higher. 31 patients with depression IL-6 and IL-2 levels were (27.32 ± 14.6) (pg / ml) and (103.76 ± 38.28) (pg / ml), significantly higher than the 28 cases of the control group (8.35 ± 5.62) ( pg / ml) and (96.08 ± 31.26) (pg / ml) levels, P lt; 0.05, the difference was statistically significant. (2) depression group (experimental group) and control group HRV time domain parameters of 31 patients with depression compared HRV time domain parameters SDNN (ms), SDANN (ms), Ln (pNN50) (%), SDNN index (ms) significantly lower than the 28 cases of the control group, P lt; 0.05, the difference was statistically significant. 3 depression group (experimental group) and control group frequency domain HRV parameters compared 31 patients with depression frequency domain HRV parameters TP (ms2/Hz), LF (ms2/Hz), HF (ms2/Hz), LF norm (nu), HF norm (nu), LF / HF (ms2/Hz) was significantly lower than the 28 cases of the control group, P lt; 0.05, the difference was statistically significant. 4 depression group (experimental group) antidepressant drug treatment serum workers L-6, IL-2 levels were significantly decreased. 31 patients with depression IL-6 and IL-2 levels of antidepressant drug treatment 14.36 ± 0.15 (pg / ml), 35.86 ± 11.03 (pg / ml) than before treatment 27.32 ± 14.6 (pg / ml), 103.76 ± 38.28 (pg / ml) significantly decreased, P lt; 0.05, the difference was statistically significant. 5 depression group (experimental group) after antidepressant treatment time domain and frequency domain HRV parameters increased significantly. 31 patients with depression antidepressant drug treatment time domain parameter SDNN (ms), SDANN (ms), Ln (pNN50) (%), SDNN index (ms), and frequency domain parameter TP (ms2/Hz), LF (ms2 / Hz), HF (ms2/Hz), LF / HF (ms2/Hz), LF norm, HF norm, LF / HF (ms2/Hz) increased significantly compared with before treatment, P lt; 0.05, the difference was statistically significant . Conclusion 1 in the pathogenesis of geriatric depression IL-6, IL-2 may play an important role, there is immunological abnormalities. 2 in elderly patients with depression HRV significantly reduced, indicating the body's autonomic nervous system regulation of heart rate damage the vagus nerve excitability is too low and (or) sympathetic activity is too high. 3 antidepressant therapy on IL-6, IL-2 and HRV have some steady improvement.

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