关键词: 情感障碍；老年人；细胞因子；神经内分泌；认知功能

Abstract:

Objective    To explore changes of serum cytokines, cortisol(Cor) levels and cognitive function of patients with affective disorders in the elderly before and after selective serotonin reuptake inhibitors(SSRIs) treatment.  Methods    50 elderly patients with affective disorder（the patient group） and 45 normal elderly subjects(the control group) were enrolled. Blood samples were used for determining serum macrophage migration inhibitory factor (MIF) by enzyme linked immunosorbent assay and IL1β, IL-6 and Cor levels by radioimmunoassay. The patient group was tested by neuropsychology scales before and after SSRIs treatment. Results     ① Before treatment, MIF, IL-1β, IL-6 and Cor levels were higher in the patient group than those in the controls and those after treatment(P<0.05). Therewas a positive correlation(P<0.01) of MIF, IL-1β, IL-6 and Cor levels with the score of the 24 item Hamilton Depression Scale(HAMD24 ) and Pittsburgh sleep quality index (PQSI) . The score of the 14 item Hamilton Anxiety Scale(HAMA14) positively correlated with levels of MIF and IL6(P<0.05).  ② Patients with affective disorder made improvements in scores of neuropsychological tests after treatment(P<0.01).  ③ The score in sleeping disturbance symptom was negatively correlated to the improvement in visuospatial and executive ability(r=-0.251, P<0.01), verbal ability(r=-0.326， P<0.01), and delay memory(r=-0.296， P<0.01), and the score in anxiety/somatization was negatively correlated to the improvement in visuospatial and executive ability(r=-0.204， P<0.01)， verbal ability(r=-0.398， P<0.01) , abstract(r=-0.307, P<0.01) and delay memory(r=-0.236， P<0.05).  Conclusion    Increasing of serum cytokines and Cor levels in patients with affective disorder in the elderly is related to the severity of anxiety and depression. SSRIs can inhibit expressions of inflammatory factors to improve cognitive function of patients.

Key words: Affective disorder; Senile； Cytokine; Neuroendocrine； Cognitive function