目的 探讨老年性白内障患者晶状体内β-淀粉样蛋白1-42(Aβ1-42)浓度与术后抑郁倾向的相关性。方法 招募2021年1月1日至12月31日在首都医科大学附属北京同仁医院行老年性白内障手术患者。选择符合纳入标准的患者,记录患者的基本情况。根据简易精神状态检查量表(MMSE)及听觉词语学习测验(AVLT)评估患者的认知功能,运用患者健康问卷(PHQ-9)评估患者抑郁状态。通过t检验比较有或无术后抑郁倾向患者晶状体内的Aβ1-42蛋白浓度,采用单因素和多因素Logistic回归分析研究相关因素与术后抑郁倾向的关联性。结果 共入选40例,术后7 d有抑郁倾向的有20例(50.0%)。有抑郁倾向的患者晶状体内Aβ1-42蛋白浓度[(67.78±20.31)pg/ml]明显高于无抑郁倾向的[(48.51±5.68)pg/ml],差异有统计学意义(t=4.086,P<0.001)。单因素Logistic回归分析结果显示,晶状体内Aβ1-42 浓度(OR=16.000,95% CI:3.398~75.345, P<0.001)是术后抑郁倾向的影响因素。多因素Logistic回归分析结果也显示晶状体内Aβ1-42 浓度(OR=16.831,95% CI:3.231~87.689,P<0.001)是术后抑郁倾向的独立危险因素,而年龄、MMSE得分、AVLT 得分与术后抑郁倾向无相关性。结论 晶状体内Aβ1-42含量与老年性白内障患者术后抑郁倾向有显著相关性。
Abstract
Objective To investigate the correlation between the concentration of β-amyloid 1-42 (Aβ1-42) in the lens of senile cataract patients and the tendency to postoperative depression.Methods Patients were recruited for senile cataract surgery in Beijing Tongren Hospital affiliated to Capital Medical University from January 1st to December 31th, 2021. Patients who met the inclusion criteria and those who did not meet the exclusion criteria were selected, and the basic conditions of the patients were recorded. The cognitive function of the patients was assessed by the Mini-Mental State Examination (MMSE) and the Auditory Word Learning Test (AVLT), and the depression status was assessed by the Depressed Mood Assessment (PHQ-9). The concentration of Aβ1-42 protein in the lens of patients with or without postoperative depression tendency was compared by t test, and the correlation between relevant factors and postoperative depression tendency was studied by univariate and multivariate Logistic regression analysis.Results A total of 40 cases were enrolled, and 20 cases (50.0%) were prone to depression at 7 days after operation. The concentration of Aβ1-42 protein in the lens of the patients with depression tendency [(67.78±20.31) pg/ml] was significantly higher than that of the patients without depression tendency [(48.51±5.68) pg/ml], and the difference was statistically significant (t=4.086, P<0.001). Univariate Logistic regression analysis showed that the concentration of Aβ1-42 in the lens (OR=16.000, 95% CI: 3.398-75.345, P<0.001) was an influencing factor for postoperative depression tendency. The results of multivariate Logistic regression analysis also showed that the concentration of Aβ1-42 in the lens (OR=16.831, 95% CI: 3.231-87.689, P<0.001) was an independent risk factor, but the postoperative depression tendency was not correlated with ag, MMSE scores or AVLT scores.Conclusions The content of Aβ1-42 in the lens is significantly correlated with the postoperative depression tendency in patients with senile cataract.
关键词
晶状体内Aβ1-42浓度 /
术后抑郁倾向 /
老年性白内障
Key words
Aβ1-42 in the lens /
tendency of postoperative depression /
senile cataract
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Ménard C, Hodes G E, Russo S J. Pathogenesis of depression: insights from human and rodent studies[J]. Neuroscience, 2016, 5(3): 138-162.
[2] Shimada H, Park H, Makizako H, et al. Depressive symptoms and cognitive performance in older adults[J]. Psychiatr Res, 2014,10(57): 149-156.
[3] Gutzmann H, Qazi A. Depression associated with dementia[J]. Z Gerontol Geriatr, 2015, 48(4): 305-311.
[4] Lee C M, Afshari N A. The global state of cataract blindness[J]. Curr Opin Ophthalmol, 2017, 28(1): 98-103.
[5] Brennan L A, McGreal R S, Kantorow M. Oxidative stress defense and repair systems of the ocular lens[J]. Front Biosci (Elite Ed), 2012, 4(1): 141-155.
[6] Schedin-Weiss S, Winblad B, Tjernberg L O. The role of protein glycosylation in Alzheimer disease [J]. FEBS J, 2014, 281(1): 46-62.
[7] Pagni G, Tagliarini C, Carbone M G, et al. Different sides of depression in the elderly: an in-depth view on the role of Aβ1-42 peptides[J]. Curr Med Chem, 2022,29(36): 5731-5757.
[8] 赵国梁, 丁 明. 血清NSE, S100β和 Aβ蛋白与老年患者术后认知功能障碍关系的临床研究[J]. 临床麻醉学杂志, 2013, 29(10): 979-982.
[9] 毕燕琳. 老年病人术后神经精神障碍的相关因素与机制探讨[D].济南:山东大学, 2014.
[10] 彭丹涛,许贤豪,刘江红,等. 简易智能精神状态检查量表检测老年期痴呆患者的应用探讨[J]. 中国神经免疫学和神经病学杂志,2005,12(4):187-190,211.
[11] Sun Y, Fu Z, Bo Q, et al. The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital [J]. BMC Psychiatry, 2020, 20(1): 1-7.
[12] Oktaviyani F. Prevalence of depression in patients with visual impairment in cataract: a systematic literature review[J]. Ophthalmology, 2022, 5(1): 113-117.
[13] Pellegrini M, Bernabei F, Schiavi C, et al. Impact of cataract surgery on depression and cognitive function: Systematic review and meta-analysis[J]. Clin Exp Ophthalmol, 2020, 48(5): 593-601.
[14] Capurso A, Capurso C, Solfrizzi V, et al. Depression in old age: a diagnostic and therapeutic challenge[J]. Recenti Prog Med, 2007, 98(1): 43-52.
[15] Eichenbaum J W. Geriatric vision loss due to cataracts, macular degeneration, and glaucoma [J]. Mt Sinai J Med, 2012, 79(2): 276-294.
[16] 常韵琪,郑 晓,李咪咪,等.老年慢性病患者抑郁状态及影响因素城乡差异研究 [J]. 中国全科医学, 2021, 24(10): 1254.
[17] Malin D H, Crothers M K, Lake J R, et al. Hippocampal injections of amyloid β-peptide 1-40 impair subsequent one-trial/day reward learning[J]. Neurobiol Learn Mem, 2001, 76(2): 125-137.
[18] Porter T, Bharadwaj P, Groth D, et al. The effects of latrepirdine on amyloid-β aggregation and toxicity[J]. J Alzheimers Dis, 2016, 50(3): 895-905.
[19] Takada E, Okubo K, Yano Y, et al. Molecular mechanism of apoptosis by amyloid β-Protein Fibrils Formed on Neuronal Cells[J]. ACS Chem Neurosci, 2020, 11(5): 796-805.
[20] O’Connor T, Borsig L, Heikenwalder M. CCL2-CCR2 signaling in disease pathogenesis[J]. Endocr Metab Immune Disord Drug Targets, 2015, 15(2): 105-118.
[21] Jarosz-Griffiths H H, Noble E, Rushworth J V, et al. Amyloid-β receptors: the good, the bad, and the prion protein[J]. J Biol Chem, 2016, 291(7): 3174-3183.
[22] Penke B, Bogár F, Paragi G, et al. Key peptides and proteins in Alzheimer's disease[J]. Curr Protein Pept Sci, 2019, 20(6): 577-599.
[23] O’Malley T T, Linse S, Walsh D M. Production and use of recombinant Aβ for aggregation studies [J]. Methods Mol Biol, 2018, 1777: 307-320.
[24] Sun X, Steffens D C, Au R, et al. Amyloid-associated depression: a prodromal depression of Alzheimer disease [J]. Arch Gen Psychiatry, 2008, 65(5): 542-550.
[25] Verdaguer E S, Stafford J, Tuijt R, et al. Minor and subthreshold depressive disorders in Alzheimer's disease: a systematic review and meta-analysis of prevalence studies[J]. J Affect Disord, 2020, 2(15): 728-734.
PDF(1000 KB)
