血清同型半胱氨酸水平对氟西汀治疗抑郁症疗效的影响  

The influence of homocysteine levels on curative effects of fluoxetine in patients with depression

作　　者：王善信[1] 殷爱华[1] 王旸[2] 

机构地区：[1]山东省精神卫生中心,济南250014 [2]山东大学医学院精神卫生研究所

出　　处：《精神医学杂志》2009年第3期177-179,共3页Journal of Psychiatry

摘　　要：目的探讨血清同型半胱氨酸对氟西汀治疗抑郁症疗效的影响。方法应用荧光偏振免疫法(Fluorescence Polarization Immunoassay,FPIA)检测38例抑郁症患者血清同型半胱氨酸水平,并给予8周氟西汀系统治疗,分别于治疗前及治疗后第8周对患者进行17项汉密尔顿抑郁量表(Hamilton rating scale for depression,HAMD17)评定。结果治疗前抑郁症患者血清同型半胱氨酸水平为(16.45±5.96)μmol/L,高同型半胱氨酸血症的发生率为42.50%;治疗前HAMD评分为(28.38±2.91),与血清同型半胱氨酸水平呈正相关(r=0.724,P=0.000)。经过治疗,全部样本中有显著疗效28例(占73.69%),有效8例(占21.05%),无效2例(占5.26%);HAMD减分率为(59.60±19.95)%,与治疗前患者的血清同型半胱氨酸水平呈负相关(r=-0.848,P=0.000)。显效组、有效组和无效组患者治疗前血清同型半胱氨酸水平分别为(14.37±2.61)μmol/L,(21.86±3.55)μmol/L,(31.93±11.96)μmol/L,三组组间比较有显著性差异(P=0.000)。高同型半胱氨酸血症组和非高同型半胱氨酸血症组患者HAMD减分率分别为(42.64±14.67)%和(73.33±11.03)%,两组比较有显著性差异(t=7.326,P=0.000)。结论血清同型半胱氨酸水平升高可能是抑郁症发病的重要危险因素之一,其对氟西汀治疗抑郁症患者的疗效有一定影响。Objective To investigate the relationship between serum homoeysteine levels and curative effects of fluoxetine in patients with depression. Methods A total of 38 patients with depression were treated with fluoxetine for 8 weeks,and serum homocysteine levels were determined by Fluorescence Polarization Immunoassay （FPIA） . They were assessed with the 17-item Hamilton Rating Scale for Depression （ HAMD 17） before and after treatment. Results The serum homocysteine level of patients with depression was 16.45±5.96 mol/ L and the incidence rate of Hyperhomocysteinemia（HHcy）was 42.50 %. Before treatment, the score of HAMD was 28.38±2.91 ,and was positively related to the serum levels of homocysteine（r=0. 724,P=0. 000）. In all patients, there were 28 patients （73.69%） in full response group, 8 patients （21. 05%） in partial response group and 2 patients （5.26 %） in non-response group. After treatment, the reduction rate of HAMD was 59.60 ±19. 95%,and negatively correlated to the serum levels of homocysteine before treatment（r=- 0. 848,P=0. 000）. There were significant differences in serum levels of homocysteine among full response, partial response and non-response groups（P=0. 000）. There was significant difference in the reduction rate of HAMD scores between the HHey group and non-HHcy group（t=7. 326,P=0. 000）. Conclusion The increase of serum homocysteine levels maybe play an important role in the pathogenic mechanism of depression. It is indicated that the serum homocysteine level has certain influence on curative effects of fluoxetine in patients with depression.

关 键 词：抑郁症 同型半胱氨酸 氟西汀 

分 类 号：R749.4[医药卫生—神经病学与精神病学]