伴抑郁的慢性湿疹患者同型半胱氨酸水平研究

Research on level of serum homocysteine in chronic eczema patients with depressive disorder

摘要:

目的 检测伴抑郁的慢性湿疹患者外周血中同型半胱氨酸水平（Hcy），并探讨其与疾病的相关性。 方法 回顾性调查2012 年6 月-2017 年6 月该院皮肤性病科门诊就诊的108 慢性湿疹患者，根据PHQ-9 抑郁 量表评分情况分为对照组47 例（不伴抑郁的慢性湿疹组）和观察组61 例（伴抑郁的慢性湿疹组）。评估两 组患者的一般临床资料。比较两组患者外周血Hcy 及维生素B12 水平，同时比较两组患者皮损面积及严重程 度指数（EASI）评分及患者瘙痒评分（VAS）。采用Spearman 法进行Hcy、维生素B12 值与伴抑郁的慢性湿 疹患者临床特征的相关性分析；并分析观察组中抑郁评分与Hcy、维生素B12 值、EASI 评分、VAS 评分的相 关性。结果 两组患者的性别、年龄和病程比较，差异无统计学意义（P >0.05）。两组外周血Hcy 水平和维生 素B12 水平比较，差异有统计学意义（P <0.05），观察组患者的外周血Hcy 水平高于对照组，维生素B12 水平 低于对照组。但两组患者的EASI 评分及VAS 评分比较，差异无统计学意义（P >0.05）。通过对观察组进行 Spearman 相关性分析发现，Hcy 水平与EASI 评分、VAS 评分呈正相关；维生素B12 水平与EASI 评分、VAS 评分呈负相关（P <0.05）。而且，Hcy 与维生素B12 水平呈负相关（r =-0.503，P =0.000）。抑郁评分与Hcy、 EASI 评分及VAS 评分呈正相关；与维生素B12 水平呈负相关（P <0.05）。结论 抑郁与慢性湿疹相互影响， Hcy 可能是其机制之一。

Abstract:

Objective To detect the level of homocysteine in peripheral blood of chronic eczema patients with depression, and to investigate the correlation between the level of homocysteine and the disease. Methods Totally 108 outpatients with chronic eczema, who were treated in Department of Dermatology in the Second Affiliated Hospital, University of South China from June 2012 to June 2017, were retrospectively collected. According to the score of PHO-9 evaluation scale for depression state, they were divided into a control group (chronic eczema patients without depression) and an observation group (chronic eczema patients with depression). General clinical information of both groups was assessed. The levels of serum homocysteine (Hcy) and vitamin B12 (Vit B12) were compared, as well as the eczema area and severity index (EASI) score and Visual AnalogueScale (VAS) score. The correlations of Hcy and Vit B12 values with the clinical features of chronic eczema patients complicated with depression were analyzed by Spearman method, and the correlations of PHQ-9 score with Hcy, Vit B12, EASI score and VAS score in the observation group were also analyzed. Results There was no significant difference in sex, age or course of disease between the two groups (P > 0.05). The peripheral blood Hcy level of the observation group was significantly higher than that of the control group, while the level of Vit B12 was significantly lower than that of the control group (P < 0.05). However, there was no significant difference in EASI score or VAS score between the two groups (P > 0.05). Through the Spearman correlation analysis of 61 patients in the observation group, Hcy level was positively correlated with EASI score and VAS score, while Vit B12 level was negatively correlated with EASI score and VAS score (P < 0.05). Moreover, Hcy was negatively correlated with Vit B12 level (r = -0.503, P = 0.000). Depression scores were positively correlated with Hcy, EASI score and VAS score, but negatively correlated with Vit B12 level (P < 0.05). Conclusions Depression and chronic eczema interact with each other, and Hcy may be involved in the middle process.