【摘要】 目的押观察抑郁症患者血浆神经肽Y水平的变化熏分析神经肽Y与抑郁症状群之间的关系。方法押病例组来源为2003-10/2004-10兰州大学第二医院住院的符合CCMD-3之抑郁症诊断标准,并排除躯体疾病和脑器质性疾病的抑郁症患者(单相)熏纳入患者32例,对照组为既往无精神疾病史及精神疾病家族史的兰州大学第二医院职工32人。病例组采用抗抑郁药选择性5-羟色胺再回收抑制剂盐酸帕罗西汀进行治疗,剂量20mg/d,1次/d,早晨口服。于治疗前和治疗后第6周末采用放射免疫法测定血浆神经肽Y的含量。对照组仅测定1次血浆神经肽Y。同时采用汉密顿抑郁量表穴24项雪、汉密顿焦虑量表穴18项雪评定症状严重程度,于治疗前、治疗后2,4,6周各评定1次。以汉密顿抑郁量表减分率为疗效评定指标。评定标准:汉密顿抑郁量表减分率≥75%为症状消失;50%≤减分率<75%为显著进步;25%≤减分率<50%为进步;<25%为无效。结果:病例组32例均完成治疗和量表评定,对照组32例均测得各项指标,并完成量表测评,全部进入结果分析。①病例组患者治疗前血浆神经肽Y水平明显低于对照组,差异有显著性意义眼穴119.18±36.3雪,穴139.18±41.0雪ng/L熏t=-2.065,P=0.043演;治疗后血浆神经肽Y水平较治疗前明显上升,差异有显著性意义眼穴128.20±36.9雪熏穴119.18±36.3雪ng/L熏t=-2.696,P=0.011演,与对照组比较差异无显著性意义(t=-1.127,P=0.264)。②随治疗的进展病例组患者汉密顿抑郁量表评分分值逐次减低,第2,4,6周末评分与治疗前相比差异有显著性意义眼(23.53±6.8),(17.62±6.9),(14.31±5.1),(34.59±7.3)分,P均<0.01演;汉密顿焦虑量表评分分值也逐次减低,第4,6周末评分与治疗前相比差异有显著性意义眼(18.34±6.5),(15.19±7.0),(11.60±6.7),(20.52±7.2)分,P均<0.01演。③病例组32例患者症状消失15例,显著进步10例,进步3例,无效4例。总有效率88%。④以血浆神经肽Y水平为因变量,以病情严重程度、病程、疗效、量表中各因子分为自变量,进行相关性分析。治疗前血浆神经肽Y的水平与汉密顿抑郁量表中的体质量减轻因子评分呈显著负相关(rs=-0.606,P<0.001);而与病情严重程度、病程、疗效结果以及量表中其他因子评分之间无相关性(P均>0.05)。结论:抑郁症患者存在血浆神经肽Y水平的降低,选择性5-羟色胺再回收抑制剂干预后能够逆转这种改变,较低的神经肽Y水平与抑郁症患者食欲减退、体质量减轻症状群有关。神经肽Y可能参与了抑郁症的病理生理过程。更多还原

【Abstract】 AIM: To explore the change of neuropeptide Y (NPY) plasma levels in depression patients and analyze the association between NPY and different symptoms of depression. METHODS: Thirty-two depression patients, diagnosed with CCMD-3 criteria and hospitalized in the Second Hospital of Lanzhou University from October 2003 to October 2004, were rolled in this study, excepting those single-phase patients with physical diseases and brain organic diseases. And 32 employees from the Second Hospital of Lanzhou University were taken as control group, without any case history and family history of psychiatry. Patients were treated with antidepressant drug selective serotonin reuptake inhibitor paroxetine by oral administration of 20 mg once in every morning. NPY plasma levels were detected by radioimmunoassay at pre-treatment and post-treatment underwent 6 weeks. While control group was only detected for one time. The severity of symptom was evaluated with 24-item Hamilton Rating Scale for Depression (HAMD-24) and 18-item Hamilton Rating Scale for Anxiety (HAMA-18) before treatment and at weeks 2, 4 and 6 after treatment, respectively. The effects were evaluated with the decrease rate of HAMD-24 scores, with the criterion: decrease rate ≥ 75% as symptom disappearance; 50% ≤ decrease rate < 75% as marked advance; 25% ≤ decrease rate < 50% as advance; < 25% as ineffectiveness. RESULTS: Both 32 patients and 32 controls completed the measuring scales and entered the result analysis.NPY plasma levels were significantly lower in the patient group than in the control group before treatment [(119.18±36.3), (139.18±41.0) ng/L, t=-2.065, P=0.043]; NPY plasma levels significantly increased in the patients group after treatment [(128.20±36.9), (119.18±36.3) ng/L, t=-2.696, P=0.011], and there was insignificant difference compared with control group (t=-1.127, P=0.264).②The scores of HAMD-24 in patients decreased gradually with the treatment extended, and there were significant differences between weeks 2, 4, 6 after treatment and before treatment [(23.53±6.8), (17.62±6.9), (14.31±5.1), (34.59±7.3) points, P < 0.01]; The scores of HAMA-18 also declined accordingly, and the difference was significant between weeks 4, 6 after treatment and before treatment [(18.34±6.5), (15.19±7.0), (11.60 ±6.7), (20.52±7.2) points, P < 0.01].③Among 32 patients, there were 15 cases presenting symptom disappearance, 10 marked advance, 3 advance and 4 ineffectiveness, with the total efficiency of 88%.④Taking the NPY plasma levels as dependent variables while the severity, progress of disease, curative effect and each factor score of measuring scales as independent variables, the correlation analysis was conducted and showed that NPY plasma levels were significantly negatively correlated with the weight loss factor scores in HAMD-24 before treatment (rs=-0.606, P < 0.001), but had no correlation with severity, progress of disease, curative effect and other factor score of measuring scales (P > 0.05).CONCLUSION: NPY plasma levels decrease in depression patients, and interventions with selective serotonin reuptake inhibitors can reverse the alterations; The low NPY levels are concerned with the symptoms of decreased food appetite and body weight loss in depression, so NPY may participate in the pathophysiological process of depression.更多还原