中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2005年
16期
246-247
,共2页
肖红%姚辉%侯刚%李箕君%郭苏皖
肖紅%姚輝%侯剛%李箕君%郭囌皖
초홍%요휘%후강%리기군%곽소환
抑郁症%生物源单胺类/代谢%精神病状态评定量表
抑鬱癥%生物源單胺類/代謝%精神病狀態評定量錶
억욱증%생물원단알류/대사%정신병상태평정량표
,背景:抑郁症的单胺假说已得到很多研究证明,但是郁症患者血浆中单胺递质代谢产物与抗抑郁治疗的相关性研究较少报道.目的:探讨不同药物治疗抑郁症患者血浆中单胺递质代谢产物的差异,以及抗抑郁治疗与抑郁患者血浆中单胺递质代谢产物水平的相关性.设计:病例对照研究.单位:南京医科大学脑科研究所和精神科.对象:抑郁症组(n=40)为南京脑科医院住院抑郁症患者,汉密顿抑郁量表总分＞17.对照组(n=20)为南京市中心血站健康志愿献血者.干预:抑郁症组均用抗抑郁药治疗4周:氟西汀[20 mg/d,5-羟色胺重摄取抑制剂类];帕罗西汀(20 mg/d,5-羟色胺重摄取抑制剂类);万拉法新[20～100 mg/d,5-羟色胺、去甲肾上腺素双重摄取抑制剂类],氟伏沙明(50～100 mg/d,去甲肾上腺素双重摄取抑制剂类).用高效液相色谱法对抑郁症患者治疗前后血浆中单胺递质代谢产物水平进行测定,用汉密顿抑郁量表评定抑郁症患者的临床疗效.主要观察指标:抑郁症患者血浆中单胺递质代谢产物5-羟吲哚乙酸、3-甲基-4-羟基苯乙二醇、高香草酸的水平.结果:抑郁症患者治疗前血浆中5-羟吲哚乙酸、3-甲基-4-羟基苯乙二醇、高香草酸的水平[(20.3±14.6),(124.8±103.6),(54.7±32.1)μg/L]均低于正常对照组[(39.5±28.4),(334.5±107.3),(88.5±37.2)μg/L],差异有显著性(P＜0.05).经5-羟色胺重摄取抑制剂治疗的抑郁症患者,5-羟吲哚乙酸含量[(37.1±21.9)μg/L]与治疗前比较明显升高,差异有显著性(P＜0.05);3-甲基-4-羟基苯乙二醇和高香草酸与治疗前比较,差异无显著性(P＞0.05);经去甲肾上腺素双重摄取抑制剂治疗后,血浆中5-羟吲哚乙酸,3-甲基-4-羟基苯乙二醇含量[(35.4±25.2),(291.2±120.4)μg/L]均比治疗前升高,差异有显著性(P＜0.05);高香草酸水平无明显变化.结论:外周的单胺递质代谢产物可反映脑中单胺类神经递质的状态,血浆中单胺类递质的变化可作为抑郁症疗效评定的一个重要参考指标.
,揹景:抑鬱癥的單胺假說已得到很多研究證明,但是鬱癥患者血漿中單胺遞質代謝產物與抗抑鬱治療的相關性研究較少報道.目的:探討不同藥物治療抑鬱癥患者血漿中單胺遞質代謝產物的差異,以及抗抑鬱治療與抑鬱患者血漿中單胺遞質代謝產物水平的相關性.設計:病例對照研究.單位:南京醫科大學腦科研究所和精神科.對象:抑鬱癥組(n=40)為南京腦科醫院住院抑鬱癥患者,漢密頓抑鬱量錶總分＞17.對照組(n=20)為南京市中心血站健康誌願獻血者.榦預:抑鬱癥組均用抗抑鬱藥治療4週:氟西汀[20 mg/d,5-羥色胺重攝取抑製劑類];帕囉西汀(20 mg/d,5-羥色胺重攝取抑製劑類);萬拉法新[20～100 mg/d,5-羥色胺、去甲腎上腺素雙重攝取抑製劑類],氟伏沙明(50～100 mg/d,去甲腎上腺素雙重攝取抑製劑類).用高效液相色譜法對抑鬱癥患者治療前後血漿中單胺遞質代謝產物水平進行測定,用漢密頓抑鬱量錶評定抑鬱癥患者的臨床療效.主要觀察指標:抑鬱癥患者血漿中單胺遞質代謝產物5-羥吲哚乙痠、3-甲基-4-羥基苯乙二醇、高香草痠的水平.結果:抑鬱癥患者治療前血漿中5-羥吲哚乙痠、3-甲基-4-羥基苯乙二醇、高香草痠的水平[(20.3±14.6),(124.8±103.6),(54.7±32.1)μg/L]均低于正常對照組[(39.5±28.4),(334.5±107.3),(88.5±37.2)μg/L],差異有顯著性(P＜0.05).經5-羥色胺重攝取抑製劑治療的抑鬱癥患者,5-羥吲哚乙痠含量[(37.1±21.9)μg/L]與治療前比較明顯升高,差異有顯著性(P＜0.05);3-甲基-4-羥基苯乙二醇和高香草痠與治療前比較,差異無顯著性(P＞0.05);經去甲腎上腺素雙重攝取抑製劑治療後,血漿中5-羥吲哚乙痠,3-甲基-4-羥基苯乙二醇含量[(35.4±25.2),(291.2±120.4)μg/L]均比治療前升高,差異有顯著性(P＜0.05);高香草痠水平無明顯變化.結論:外週的單胺遞質代謝產物可反映腦中單胺類神經遞質的狀態,血漿中單胺類遞質的變化可作為抑鬱癥療效評定的一箇重要參攷指標.
,배경:억욱증적단알가설이득도흔다연구증명,단시욱증환자혈장중단알체질대사산물여항억욱치료적상관성연구교소보도.목적:탐토불동약물치료억욱증환자혈장중단알체질대사산물적차이,이급항억욱치료여억욱환자혈장중단알체질대사산물수평적상관성.설계:병례대조연구.단위:남경의과대학뇌과연구소화정신과.대상:억욱증조(n=40)위남경뇌과의원주원억욱증환자,한밀돈억욱량표총분＞17.대조조(n=20)위남경시중심혈참건강지원헌혈자.간예:억욱증조균용항억욱약치료4주:불서정[20 mg/d,5-간색알중섭취억제제류];파라서정(20 mg/d,5-간색알중섭취억제제류);만랍법신[20～100 mg/d,5-간색알、거갑신상선소쌍중섭취억제제류],불복사명(50～100 mg/d,거갑신상선소쌍중섭취억제제류).용고효액상색보법대억욱증환자치료전후혈장중단알체질대사산물수평진행측정,용한밀돈억욱량표평정억욱증환자적림상료효.주요관찰지표:억욱증환자혈장중단알체질대사산물5-간신타을산、3-갑기-4-간기분을이순、고향초산적수평.결과:억욱증환자치료전혈장중5-간신타을산、3-갑기-4-간기분을이순、고향초산적수평[(20.3±14.6),(124.8±103.6),(54.7±32.1)μg/L]균저우정상대조조[(39.5±28.4),(334.5±107.3),(88.5±37.2)μg/L],차이유현저성(P＜0.05).경5-간색알중섭취억제제치료적억욱증환자,5-간신타을산함량[(37.1±21.9)μg/L]여치료전비교명현승고,차이유현저성(P＜0.05);3-갑기-4-간기분을이순화고향초산여치료전비교,차이무현저성(P＞0.05);경거갑신상선소쌍중섭취억제제치료후,혈장중5-간신타을산,3-갑기-4-간기분을이순함량[(35.4±25.2),(291.2±120.4)μg/L]균비치료전승고,차이유현저성(P＜0.05);고향초산수평무명현변화.결론:외주적단알체질대사산물가반영뇌중단알류신경체질적상태,혈장중단알류체질적변화가작위억욱증료효평정적일개중요삼고지표.
BACKGROUND: Monoamine hypothesis has been demonstrated by researches. However, the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression has less been reported.OBJECTIVE: To study the effect of different drugs on metabolite of plaama monoamine neurotransmitter, and the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression.DESIGN: Case controlled study.SETTING: Neurological Department and Brain Institute of Nanjing Medical University.PARTICIPANTS: Forty patients with depression hospitalized in Nanjing Brain Hospital (depression group) were diagnosed with the second revised edition of China classification of mental diseases(CCMD-2) and the tenth edition of International classification of diseases. And the total score of Hanmilton rating scale for depression(HAMD) was more than 17. Healthy voluntary blood donators in the control group were from Nanjing Municipal Central Blood Station( n = 20).INTERVENTIONS: Antidepressant was used in the depression for 4 weeks: fluoxetine 20 mg per day; 5-serotonin selective reuptake inhibitor (SSRI) paroxetine 20 mg per day; venlafaxime 50- 100 mg per day;5-serotonin and morepinephrine selective reuptake inhibitor(SNRI) fluvoxamine 50-100 mg per day. High performance liquid chromatograpy(HPLC)was used to measure the level of metabolite of plasma monoamine neurotransmitter in patients with depression before and 42 week after treatment, and the HAMD was used to evaluate clinical effect of the patients.MAIN OUTCOME MEASURES: The levels of metabolites of plasma monoamine neurotransmitters in patients with depression: 5-hydroxyindoleace tic acid(5-HIAA), 3-methoxy-4-hydroxyphenylglycol(MHPG) and homovani llic acid(HVA) were measured before and 4th week after treatment.RESULTS: The levels of 5-HIAA, MHPG and HVA of the metabolites of plasma monoamine neurotransmitters in patients with depression before treatment [ (20.3±14.6), (124.8±103.6), (54.7±32.1) μg/L] were all lower than those in the normal control group[ (39.5±28.4), (334.5 ±107.3), (88.5±37.2) μg/L], with statistically significant differences (P＜0.05). After SSRI treatment, the 5-HIAA content[ (37.1±21.9)μg/L]was significantly increased as compared with that before treatment, whose difference indicated significant meaning ( P＜0.05), but the differences in MHPG and HVA had no significant meaning as compared with those before treatment(P＞0.05) . After SNRI treatment, 5-HIAA and MHPG contents [(35.4±25.2 ), (291.2±120.4) μg/L] both were significantly increased, which indicated significant difference as compared with those before treatment( P＜0.05); but HVA level had no significant changes.CONCLUSION:'The peripheral neurotransmitter metabolites in plasma can reflect their states in brain. The change of neurotransmitter metabolite in plasma can be regarded as an important reference index for the evaluation of depression.
