慢性失眠患者过度觉醒与血清炎症细胞因子的相关性研究

Study on Correlation between Hyperarousal and Serum Inflammatory Factors Expression in Patients with Chronic Insomnia Disorder

摘要: 目的：探讨慢性失眠患者血清炎症细胞因子与过度觉醒的关系。方法：以方便取样法选取慢性失眠患者(失眠组)40例，选取健康体检人员(对照组)30例。采用过度觉醒量表和睡前觉醒量表对两组被试进行评定。对所有被试在入组后采集清晨空腹肘静脉血，测定IL-6、IL-8、TNF-α和IFN-γ等血清炎症细胞因子水平。使用SPSS22.0统计方法进行单因素和多因素分析。结果：失眠组和对照组外周血IL-6 [(125.38 ± 93.88) pg/ml和(4.23 ± 3.44) pg/ml]、IL-8 [(346.6 ± 253.00) pg/ml和(3.57 ± 2.04) pg/ml]水平比较，失眠组增高，差异有统计学意义(P均 < 0.001)。Pearson相关分析显示：失眠组IL-6与睡前觉醒和过度觉醒程度得分存在相关性(r = 0.335~0.428, 0.335, P ˂ 0.001)，IL-8与睡前觉醒、过度觉醒得分存在相关性(r = 0.321, 0.467, P ˂ 0.05)。多元逐步回归分析结果显示：失眠组IL-6 (t = 2.220, P = 0.033)和文化程度(t = 2.216, P = 0.033)进入以慢性失眠患者过度觉醒总分为因变量的回归方程。IL-8 (t = 3.098, P = 0.004)和文化程度(t = 2.373, P = 0.023)进入以慢性失眠患者睡前觉醒总分为因变量的回归方程。结论：IL-6影响慢性失眠患者过度觉醒，IL-8影响慢性失眠患者睡前觉醒，文化程度与慢性失眠患者过度觉醒与睡前觉醒有关。

Abstract: Objective: To explore the correlation between the hyperarousal and serum inflammatory factor expression in patients with chronic insomnia disorder. Methods: 40 chronic insomnia disorders patients and 30 normal subjects were recruited in the present study. Serum levels of inflammatory factors were determined with enzyme-linked immune sorbent assay (ELISA). The Hyperarousal Scale (HAS) and the Presleep Arousal Scale (PSAS) were used to assess hyperarousal and presleep arousal of chronic insomnia disorder of the subjects, then employing SPSS22.0 for t-test, correlative analysis and regressive analysis. Results: The serum level of IL-6 [(125.38 ± 93.88) pg/ml vs (4.23 ± 3.44) pg/ml], IL-8 [(346.6 ± 253.00) pg/ml vs (3.57 ± 2.04) pg/ml] [(42.87 ± 4.42) g/L vs (44.89 ± 3.00) g/L, P < 0.05] was significantly higher in patients with chronic insomnia disorder than that of normal control. Pearson correlation showed that education level was correlated with hyperarousal and presleep arousal (r = 0.381, 0.335, P ˂ 0.05); IL-6 was correlated with hyperarousal and presleep arousal Insomnia Severity (r = 0.335~0.428, 0.335, P ˂ 0.001); IL-8 was correlated with hyperarousal and presleep arousal (r = 0.321, 0.467, P ˂ 0.05). Regression analysis showed that IL-6 (t = 2.220, P = 0.033) and education level (t = 2.216, P = 0.033) were the influencing factors of hyperarousal. IL-8 (t = 3.098, P = 0.004) and education level (t = 2.373, P = 0.023) were the influencing factors of presleep arousal. Conclusion: The inflammatory factors might be involved in the pathophysiology of chronic insomnia disorder, IL-6 may correlate with the severity of hyperarousal, and IL-8 may correlate with the severity of presleep arousal in patients with chronic insomnia disorder. The education level will exert significant effects on the hyperarousal and presleep arousal.