The Change And Significance Of IL-6,IL-2 And HRV In Eiderly Depression

The depression is one kind of common psychological,mental disorder, every year approximately has 15% about crowd to be sick, our country approximately has 26 million.World Health Organization (WHO) in the "World Health Report 2001" emphasized that depression has become the world's fourth-largest disease by 2020 and will be the most serious of the disease burden in developing countries.China is the world's largest developing country, the largest population, with the aging of the country into the ranks of the elderly,as a special group in our society, old-age depression is more prominent, has become more common after Alzheimer's disease mental disorder, is increasingly being valued by people.In recent years, cytokines and elderly depression occurrence and development of the close correlation and change of heart rate variability (HRV) caused by elderly depression and then induce cardiovascular disease has been increasingly clinicians are taken seriously.Many foreign study found that cytokines can cause depression, the contrary depression can also cause change of cytokines and HRV and then induce and increase cardiovascular disease, and impact on the prognosis of the disease, their study suggests that depression is cardiovascular disease, development and independent risk factor affecting prognosis.The interaction between elderly depression and cytokines and HRV mechanism has not a complete theory to clearly spelled out by now. Existing theory shows a kind of coronary heart disease is endothelial damage, chronic inflammatory response, while depression is accompanied by the immune inflammatory response.In this paper, determination of geriatric depression in patients with immune-inflammatory cytokines interleukin-6 (IL-6), interleukin-2 (IL-2) level's change and 24-hour ambulatory electrocardiogram (DCG) of heart rate variability (HRV) change to analysis of elderly depression and cytokines and the link between cardiac autonomic nervous, of which the mechanism for clinical work to provide some new ideas.Object of study and methods1.The object of study:Depression group (experimental group) collected from August 2008 to October 2009 period the First Affiliated Hospital of Zhengzhou University, Geriatrics inpatients. Into the group of standards:①In line with China's mental illness (mental disorder) classification schemes and diagnostic criteria (CCMD-3),mental health symptom checklist (SCL-90) 2 level or factor score of≥3 points and Hamilton depression scale≥2 level were;②Age>60years, without alcohol and drug abuse history. Elimination standard:③The organic barrier, or the energetic active material and must becomes addicted to the material result to be despondent;②Manifests suddenly many times, near one year internal medicine has used the immunity conditioner, the anti-despondent medicine, the lithium salt and so on;③Accepts the charging twitching curer;④In nearly one month contracts cold, to have a fever and so on communicable diseases;⑤Contracts the endocrine disease, hepatorenal and so on serious body disease;⑥Laboratory inspection obvious unusualities and so on routine blood test, liver function, kidney function;⑧Illiterate person. And masculine 15 examples, feminine 16 examples, average age (67.2±5.6) year old. Gender, age was no significant difference (P>0.05).Reference Group And depression group choose the same period in 28 patients with normal physical and mental health of older persons require no family history of mental illness, no history of alcohol and substance abuse in recent months without a cold, fever, history of infectious diseases. Elimination standard:①Family history of mental illness;②Illiterate person.14 cases were males and 14 females, mean age (66.8±5.3)years of age. Compared two groups of gender,age,no significant difference (P> 0.05).More participants of this study were informed consent.2.Methods:Enzyme-linked immunosorbent assay (ELISA) determination of 31 cases of elderly patients with depression before and after antidepressant treatment,28 patients without mental disabilities, serum IL-6, IL-2 levels. Physiological recorder with four of the above 59 cases were aged 24-hour ambulatory electrocardiogram (DCG) waveform recorded. Will be detected in 24-hours dynamic electrocardiogram (DCG) of heart rate variability (HRV) time domain analysis and frequency domain analysis.3.Statistics processing:Statistics processing all data pass through the SPSS13.0 statistics software to carry on processing, the measurement material with x±s the expression, carries on the normality examination, conforms to the normal distribution to use groups the T-test, does not conform to the normal distribution to use the order and the examination, examination standard=0.05,P<0.05 the difference has statistics significance.Results1.Depression group (experimental group) of IL-6, IL-2 levels were significantly higher than the reference group.Group of 31 cases of depression IL-6 and IL-2 levels were (27.32±14.6) (pg/ml), and(103.76±38.28) (pg/ml), significantly higher than 28 cases of the control group (8.35±5.62)(pg/ml), and (96.08±31.26)(pg/ml) levels, P<0.05,the difference was statistically significant.2.Depression group (experimental group) and the Reference Group Comparison of HRV time domain parameters.Depression group 31 cases of HRV time domain parameters of SDNN (ms), SDANN(ms),Ln (pNN50)(%), SDNN index (ms) was significantly lower than 28 cases of the control group, P<0.05 The difference was statistically significant.3.Depression group (experimental group) and the Reference Group Comparison of HRV frequency domain parametersGroup of 31 cases of 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 28 cases of the control group, P<0.05,the difference was statistically significant.4. Depression group (experimental group) antidepressant drug treatment serum IL-6, IL-2 levels dropped significantly.Group of 31 cases of depression IL-6 and IL-2 levels of antidepressant drugs after treatment 14.36±0.15 (pg/ml),35.86±11.03 (pg/ml) compared with pre-treatment 27.32±14.6(pg/ml),103.76±38.28 (pg/ml) decreased significantly, P<0.05,the difference was statistically significant.5.Depression group (experimental group) after antidepressant drug treatment in time domain and frequency domain HRV parameters increased significantly.Group of 31 cases of depression after antidepressant drug treatment SDNN (ms), SDANN (ms),Ln(pNN50) (%), SDNN index (ms) and TP (ms2/Hz), LF(ms2/Hz), HF(ms2/Hz), LF norm,HF norm,LF/HF(ms2/Hz) increased significantly compared with before treatment, P<0.05,the difference was statistically significant.Conclusions1.The pathogenesis of depression in the elderly, IL-6, IL-2 may play an important role; and the existence of immunological abnormalities.2.Depression in elderly patients, HRV decreased, indicating the body vagus nerve excitability is too low and (or) excessive sympathetic excitability.3.Antidepressant treatment may affect the IL-6, IL-2 and HRV.