文献类型：期刊文献

中文题名：伴无症状性脑梗死抑郁症血清皮质醇变化研究

英文题名：Analysis of serum cortisol abnormalities in patients with major depression and asymptomatic cerebral infarction

作者：张静霞[1];张兰[2]

第一作者：张静霞

机构：[1]甘肃中医学院附属医院神经心理科;[2]兰州大学第二医院心理卫生中心

第一机构：甘肃中医药大学第二附属医院

年份：2010

期号：19

起止页码：1665

中文期刊名：临床荟萃

外文期刊名：Clinical Focus

基金：兰州大学医学科研基金课题(04129)

语种：中文

中文关键词：脑梗塞;抑郁症;皮质醇

外文关键词：brain infarction; depression disorder; cortisol

摘要：目的通过检测伴无症状性脑梗死(asymptomatic cerebral infarction ACI)抑郁症患者治疗前后血清皮质醇水平含量,分析血管性抑郁神经内分泌改变。方法采用病例对照研究的方法,抑郁症患者66例为病例组,依照CT检查结果分为伴无症状性脑梗死(ACI+)抑郁症组31例和无脑梗死(ACI-)抑郁症组35例。同时以健康体检者35例为正常对照。用放射免疫法测皮质醇。应用汉密尔顿抑郁量表(HAMD)评定抑郁程度。结果 ACI+抑郁症组皮质醇水平高于正常对照组,(174.53±81.86)μg/L vs(110.00±50.00)μg/L(P<0.05);治疗前及治疗后ACI+抑郁症组与ACI-抑郁症组血清皮质醇水平差异无统计学意义(P>0.05);盐酸帕罗西汀治疗后ACI+抑郁症组、ACI-抑郁症组血清皮质醇降低(P<0.05或<0.01);治疗前及治疗后ACI+抑郁症组HAMD评分较ACI-抑郁症组高(P<0.01);治疗6周时ACI+抑郁症组治愈率低于ACI-抑郁症组(35.5%vs 80.0%,P<0.01);两组血清皮质醇水平均与HAMD各因子无相关性(P>0.05)。结论 ACI+抑郁症患者存在下丘脑-垂体-肾上腺轴的改变,与其他抑郁症相比这种改变存在一致性;ACI+抑郁症患者抑郁程度更重,疗效较差。
Objective As a subtype of depression,vascular depression has its particularity in clinical manifestation,neuro-imaging characteristics,and treatment outcome.The changes of serum cortisol in depressed patients with asymptomatic cerebral infarction（ACI） were investigated.Methods According to brain computerized topography results,we classified 66 depression patients into two groups-those with ACI＋（n=31） and ACI-（n=35）,simutaneously normal controls were taken from healthy body-check.The two groups′ patients were compared on serum cortisol.Cortisol was conducted by radioimmunoassay.Hamilton Depression Scale（HAMD） was used to assess the depressive symptoms before and after treatment.Results Patients′ group was higher than normal controls before treatment in serum cortisol,（174.53±81.86） μg/L vs（110.00±50.00） μg/L（P0.05）.No significant difference was found after paroxetine taken for two weeks between the ACI＋group and ACI-group in serum cortisol（P0.05）.Serum cortisol decreased after trentment in ACI＋group and ACI-group（P0.05,P0.01）.The ACI＋group showed higher HAMD scores than ACI-before and after treatment,the effective rate was lower than ACI-after six weeks.Serum cortisol had no correlation with HAMD.Conclusion Depression with asymptomatic cerebral infarction has been associated with changes in the hypothalamus-pituitary-adrenal axis as well as noasymptomatic cerebral infarction;HAMD score was higher and the effective rate was lower in depression with ACI＋ as compared with ACI-.