中华行为医学与脑科学杂志
中華行為醫學與腦科學雜誌
중화행위의학여뇌과학잡지
CHINESE JOURNAL OF BEHAVIORAL MEDICINE AND BRAIN SCIENCE
2010年
1期
33-35
,共3页
崔青%孙丽亚%肖红%侯钢
崔青%孫麗亞%肖紅%侯鋼
최청%손려아%초홍%후강
抑郁症%晨重夕轻%下丘脑-垂体-肾上腺轴%下丘脑-垂体-甲状腺轴
抑鬱癥%晨重夕輕%下丘腦-垂體-腎上腺軸%下丘腦-垂體-甲狀腺軸
억욱증%신중석경%하구뇌-수체-신상선축%하구뇌-수체-갑상선축
Depressive disorders%Diurnal rhythm%HPA axis%HPT axis
目的 探讨抑郁症患者下丘脑-垂体-肾上腺(HPA)轴、下丘脑-垂体-甲状腺(HPT)轴的功能和节律变化与临床症状晨重夕轻之间的关系.方法 采用放射免疫法对49例符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)重性抑郁发作患者及38例对照组,对早7:00、晚7:00血浆皮质醇(CORT)、促肾上腺皮质激素(ACTH)、三碘甲状腺原胺酸(T3)、四碘甲状腺原胺酸(T4)、甲状腺刺激素(TSH)水平进行测定,采用多因素方差分析比较2组各项指标的变化、并与临床症状之间的关系进行分析.结果 病例组早晨血浆CORT、早晨、晚间TSH水平[分别为(365.94±120.78)nmol/L,(6.24±2.47)μIU/ml,(6.68±2.42)±IU/ml]较对照组[(284.91±83.39)nmol/L,(3.82±1.75)±IU/ml,(4.01±1.69)μIU/ml]明显增高,差异有显著性(P<0.05);病例组早晨、晚间血浆T4水平较对照组显著降低(P<0.05);血浆皮质醇水平的早晚变化在病例组与对照组之间差异有显著性(P<0.001);病例组血浆CORT、T3、T4、TSH水平的早晚变化在单相和双相抑郁障碍、伴有和不伴有精神病性症状的临床亚型之间均差异无显著性(均P>0.05).结论 抑郁症患者血浆皮质醇水平存在早晚异常变化,可能是抑郁症的一项特异的生物学标志.
目的 探討抑鬱癥患者下丘腦-垂體-腎上腺(HPA)軸、下丘腦-垂體-甲狀腺(HPT)軸的功能和節律變化與臨床癥狀晨重夕輕之間的關繫.方法 採用放射免疫法對49例符閤美國精神障礙診斷與統計手冊第4版(DSM-Ⅳ)重性抑鬱髮作患者及38例對照組,對早7:00、晚7:00血漿皮質醇(CORT)、促腎上腺皮質激素(ACTH)、三碘甲狀腺原胺痠(T3)、四碘甲狀腺原胺痠(T4)、甲狀腺刺激素(TSH)水平進行測定,採用多因素方差分析比較2組各項指標的變化、併與臨床癥狀之間的關繫進行分析.結果 病例組早晨血漿CORT、早晨、晚間TSH水平[分彆為(365.94±120.78)nmol/L,(6.24±2.47)μIU/ml,(6.68±2.42)±IU/ml]較對照組[(284.91±83.39)nmol/L,(3.82±1.75)±IU/ml,(4.01±1.69)μIU/ml]明顯增高,差異有顯著性(P<0.05);病例組早晨、晚間血漿T4水平較對照組顯著降低(P<0.05);血漿皮質醇水平的早晚變化在病例組與對照組之間差異有顯著性(P<0.001);病例組血漿CORT、T3、T4、TSH水平的早晚變化在單相和雙相抑鬱障礙、伴有和不伴有精神病性癥狀的臨床亞型之間均差異無顯著性(均P>0.05).結論 抑鬱癥患者血漿皮質醇水平存在早晚異常變化,可能是抑鬱癥的一項特異的生物學標誌.
목적 탐토억욱증환자하구뇌-수체-신상선(HPA)축、하구뇌-수체-갑상선(HPT)축적공능화절률변화여림상증상신중석경지간적관계.방법 채용방사면역법대49례부합미국정신장애진단여통계수책제4판(DSM-Ⅳ)중성억욱발작환자급38례대조조,대조7:00、만7:00혈장피질순(CORT)、촉신상선피질격소(ACTH)、삼전갑상선원알산(T3)、사전갑상선원알산(T4)、갑상선자격소(TSH)수평진행측정,채용다인소방차분석비교2조각항지표적변화、병여림상증상지간적관계진행분석.결과 병례조조신혈장CORT、조신、만간TSH수평[분별위(365.94±120.78)nmol/L,(6.24±2.47)μIU/ml,(6.68±2.42)±IU/ml]교대조조[(284.91±83.39)nmol/L,(3.82±1.75)±IU/ml,(4.01±1.69)μIU/ml]명현증고,차이유현저성(P<0.05);병례조조신、만간혈장T4수평교대조조현저강저(P<0.05);혈장피질순수평적조만변화재병례조여대조조지간차이유현저성(P<0.001);병례조혈장CORT、T3、T4、TSH수평적조만변화재단상화쌍상억욱장애、반유화불반유정신병성증상적림상아형지간균차이무현저성(균P>0.05).결론 억욱증환자혈장피질순수평존재조만이상변화,가능시억욱증적일항특이적생물학표지.
Objective To study the function and diurnal variation of hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-thyroid(HPT) axis,and the relationship with clinical characteristics of di-urnal rhythm in depressed patients. Methods Forty-nine depressed patients met diagnostic DSM-Ⅳ criteria and thirty-eight normal controls were collected. The plasma levels of cortisol (CORT), adrenocorticotropic hormone (ACTH), T3, T4, thyroid-stimulating hormone (TSH) at 7 am and 7 pm were measured by radioimmunoassay, then the results concemed were compared among the depressed groups with and without diurnal variation and control group by multivariate analysis of variance. Results The plasma level of morning CORT, morning and evening TSH ((365.94±120.78) nmol/L; (6.24±2.47)μIU/ml; (6.68±2.42)μIU/ml; respectively) were respective-ly higher than those of control group((284.91±83.39) nmol/L; (3.82±1.75)μIU/ml;(4.01±1.69)μIU/ ml, P<0.05). The plasma levels of morning and evening T4 were significantly lower than those of control group(P <0.05). The CORT morning-evening difference variable distinguished between depressed and control group (P< 0.001),but no significant differences could be found between the depressed groups with and without diurnal varia-tion. There were no significant differences in the CORT, T3, T4, TSH morning-evening difference variable between various clinical subtypes of depressed patient (unipolar/bipolar; psychotic/nonpsychotic). Conclusion Abnormal CORT morning-evening difference variable was observed in the depressed patients compared with normal controls,and may be used as a special trait mark of depressed group.
