伴白质病变的抑郁症状的临床特征分析  

Relationship of white matter lesions to the symptom profiles of middle-aged patients with depression

作　　者：吴恒趋[1] 张瑛[1] 李焰生[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经内科,硕士在读200127

出　　处：《上海精神医学》2010年第5期271-274,共4页Shanghai Archives of Psychiatry

摘　　要：目的研究伴白质病变（white matter lesions,WML）的抑郁患者的临床特征。方法对69例在上海交通大学医学院附属仁济医院神经内科门诊就诊的抑郁患者,根据白质病变情况分为无WML组、轻度WML组及中～重度WML3组比较其基本特征和汉密尔顿抑郁量表评分。结果与无WML者相比,伴随有中～重度WML的抑郁症患者年龄较高（t=-4.1,P=0.021）、婚姻状况差（χ^2=10.55,P=0.005）、受教育程度低（χ^2=15.23,P=0.002）、经济水平差（χ^2=10.74,P=0.013）。与无WML组、轻度WML组患者相比,中～重度WML组抑郁患者在焦虑/躯体化（躯体性焦虑、精神性焦虑、疑病）、认识障碍（有罪感）、阻滞（抑郁情绪、阻滞）方面的评分有统计学差异（均P〈0.05）。结论伴中～重度WML的抑郁患者的临床特征不同于无或轻度WML的患者。Objective：Compare the clinical characteristics of middle-aged depressed patients with and without white matter lesions（WML）.Methods：Sixty-nine patients with major depression according to DSM-IV criteria identified at the neurological outpatient department of the Renji Hospital of the Shanghai Jiaotong University were classified into three groups based on the results of a MRI examination：no WML,mild WML,or moderate-to-severe WML.The demographic characteristics and the results of the Hamilton rating scale for Depression were compared between the three groups of subjects.Results：Compared to those with no WML,subjects with mild-to-severe WML were older（t=-4.1,P=0.021）,had poor marital status（χ^2=10.55,P=0.005）,had less education（χ^2=15.23,P=0.002）and had lower incomes（χ^2=10.74,P=0.013）.Compared to subjects with mild or no WML,those with moderate-to-severe WML had significantly lower levels of depressive affect and guilt but higher levels of psychomotor retardation,somatic anxiety,psychic anxiety and hypochondriacal ideation（all Ps〈0.05）.Conclusion：The clinical characters of middle-aged depressed patients with moderate-to-severe WML are different from those of depressed patients with mild WML or no WML.

关 键 词：脑 白质病变 中年 抑郁 

分 类 号：R749.1[医药卫生—神经病学与精神病学]