职业性噪声性聋并抑郁症状患者的皮质醇及免疫水平研究

The Level of Cortisol and Inflammatory Factors in Patients with Occupational Noise-induced Hearing Loss Correlated with Depressive Symptoms

邓小峰;虢远宁;李聪;樊春月;石国旗;陈永君;吴奇峰;

1:广州中医药大学针灸康复临床医学院

2:广东省职业病防治院广东省职业病防治重点实验室

摘要
目的探讨职业性噪声性聋患者体内皮质醇水平及相关炎症细胞因子的变化与听力损伤后抑郁情绪发生的相关性。方法以2016年3月至2017年10月入住广东省职业病防治院的职业性噪声性聋患者为研究对象,根据抑郁自评量表得分分为合并抑郁症状组57例和未合并抑郁症状组(单纯噪声性聋组)49例,分别检测2组外周血皮质醇(COR)水平及相关免疫因子,如:淋巴细胞亚群(B淋巴细胞、NK细胞及T淋巴细胞亚群)、炎症细胞因子如肿瘤坏死因子-a(TNF-a)、白细胞介素-6(IL-6)及C反应蛋白(CRP)的变化。结果 (1)职业性噪声性聋合并抑郁症状组外周血清COR水平明显高于单纯噪声性聋组(P<0.05);(2)职业性噪声聋合并抑郁症状组患者NK细胞百分比较单纯噪声聋组高,而B细胞、CD8+T细胞所占淋巴细胞的百分比较单纯噪声性聋组低(P<0.05),但两组间CD3+T细胞所占淋巴细胞的百分比较单纯噪声性聋组低(P<0.05),但两组间CD3+、CD4+、CD4+及CD4+及CD4+/CD8+/CD8+T细胞的水平差异无统计学意义(P>0.05);(3)噪声性聋合并抑郁症状组患者IL-6、TNF-a水平高于单纯噪声性聋组(P<0.05),但两组患者的CRP水平差异无统计学意义(P>0.05);(4)Logistic回归分析结果显示,COR、TNF-a水平越高,CD3+T细胞的水平差异无统计学意义(P>0.05);(3)噪声性聋合并抑郁症状组患者IL-6、TNF-a水平高于单纯噪声性聋组(P<0.05),但两组患者的CRP水平差异无统计学意义(P>0.05);(4)Logistic回归分析结果显示,COR、TNF-a水平越高,CD3+CD8+CD8+T细胞水平越低,发生抑郁的可能性越大(P<0.05)。结论职业性噪声性聋伴抑郁症状的患者COR水平及炎症因子IL-6、TNF-a水平升高,且与抑郁的发生密切相关,表明噪声暴露后下丘脑-垂体-肾上腺轴(HPA轴)功能失调、免疫激活及炎症细胞因子的释放增多可能是导致其并发抑郁的机制之一。
关键词
职业性噪声性聋;抑郁症状;皮质醇;淋巴细胞亚群;免疫因子
基金项目(Foundation):
国家临床重点专科建设项目(2011-09);; 广东省职业病防治重点实验室基金项目(2012A061400007);; 广东省医学科研基金项目(B2018211)
作者
邓小峰;虢远宁;李聪;樊春月;石国旗;陈永君;吴奇峰;
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