抑郁症患者接受治疗前后血浆单胺类神经递质代谢产物的差异(英文)  

Plasma metabolite change of monoamine neurotransmitters in patients with depression after treatment

作　　者：肖红[1] 姚辉[2] 侯刚[2] 李箕君[2] 郭苏皖[2] 

机构地区：[1]南京医科大学脑科医院研究所,江苏省南京市210029 [2]南京医科大学脑科医院精神科,江苏省南京市210029

出　　处：《中国临床康复》2005年第16期246-247,共2页Chinese Journal of Clinical Rehabilitation

基　　金：南京市医学科技发展项目基金资助(YKK0350)~~

摘　　要：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[20mg/d,5-羟色胺重摄取抑制剂类];帕罗西汀(20mg/d,5-羟色胺重摄取抑制剂类);万拉法新[20～100mg/d,5-羟色胺、去甲肾上腺素双重摄取抑制剂类],氟伏沙明(50～100mg/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],BACKGROUND:Monoamine hypothesis has been demonstrated by researches.However,th e correlation between the metabolite of plasma monoamine neurotransmitter and an ti depression treatment in patients with depression has less been reported. OBJECTIVE:To study the effect of different drugs on metabolite of plasma monoa mine neurotransmitter,and the correlation between the metabolite of plasma monoa mine neurotransmitter and anti depression treatment in patients with depression . DESIGN:Case controlled study. SETTING:Neurological Department and Brain Institute of Nanjing Medical Univers ity. PARTICIPANTS:Forty patients with depression hospitalized in Nanjing Brain Hosp ital (depression group) were diagnosed with the second revised edition of China classification of mental diseases(CCMD 2) and the tenth edition of Internationa l classification of diseases.And the total score of Hanmilton rating scale for d epression(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 monoa mine neurotransmitter in patients with depression before and 4th week after trea tment,and the HAMD was used to evaluate clinical effect of the patients. MAIN OUTCOME MEASURES:The levels of metabolites of plasma monoamine neurotrans mitters in patients with depression:5 hydroxyindoleace tic acid(5 HIAA),3 met hoxy 4 hydroxyphenylglycol(MHPG) and homovani llic acid(HVA) were measured bef ore and 4th week after treatment. RESULTS:The levels of 5 HIAA,MHPG and HVA of the metabolites of plasma monoam ine neurotransmitters in patients with depression before treatment [(20.3±14.6) ,(124.8±103.6

关 键 词：抑郁症 生物源单胺类/代谢 精神病状态评定量表 

分 类 号：R749.72[医药卫生—神经病学与精神病学]