Changes Of IL-6 In Patients With Depression After ECT And The Relationship With Curative Effect:A Systematic Review And Metaanalysis

Objective: To systematically evaluate the changes of IL-6 level in patients with depression during electroconvulsive therapy(ECT)and the relationship with curative effect.Methods: Chinese databases CNKI,sinomed,Wanfang,VIP and foreign databases Pub Med,web of science,Cochrane Library and EMBASE were searched by computer to investigate the changes of inflammatory factor IL-6 in patients with depression after ECT treatment.The retrieval time is from the establishment of the database to December 2021.Two evaluators independently screened the literature,extracted data and evaluated the literature quality.Qualitative analysis was carried out first,and then meta-analysis was carried out by Stata software.Result: Thirteen studies were eligible.470 patients,unipolar and bipolar,were included in the studies.Meta results showed that the level of IL-6 in patients after repeated ECT treatment decreased compared with that before treatment [randomeffect model,SMD=0.49,95% CI(0.11,0.88)],and a single ECT could increase the level of IL-6 in patients in a short time [fixed-effect model,SMD=-0.58,95% CI(-1.02,-0.15)].Meta regression analysis of relevant factors showed that the time of sample collection and race were the factors affecting heterogeneity.We made a descriptive analysis of the relationship between the changes of IL-6 level and curative effect before and after treatment.Most research results show that there is no significant correlation between the changes of IL-6 level and the reduction of depression scale score,but some studies have found that there is a significant difference in the changes of IL-6 level between the two groups with or without response to ECT treatment.Conclusion: Electroconvulsive therapy can regulate the neuroimmune function of patients with depression.Single ECT can cause inflammatory reaction and make the level of IL-6 rise acutely and briefly.However repeated ECT treatment have antiinflammatory effect,that is,after repeated ECT treatment,the level of IL-6 in peripheral blood will gradually decrease,and the depressive symptoms of patients will be relieved,but its relationship still needs to be further explored.