抑郁症患者血清胰岛素及神经内分泌激素的临床研究  

Clinical study of serum insulin and neuroendocrine hormones in patients with depression

作　　者：黄成兵[1] 陈桂兵[1] 李坚[1] 

机构地区：[1]淮安市第三人民医院精神科,223001

出　　处：《神经疾病与精神卫生》2012年第6期567-570,共4页Journal of Neuroscience and Mental Health

基　　金：淮安市科技支撑计划（工业、社会发展）项目（HAS08019）

摘　　要：目的研究抑郁症患者血清胰岛素及神经内分泌激素的改变以及与临床症状的相关性。方法入组抑郁症患者120例为研究组，健康者60例为对照组，使用汉密尔顿抑郁量表（HAMD）评估患者的临床症状，检测患者和健康者的血清胰岛素、皮质醇（CORT）、促肾上腺皮质激素（ACTH）、三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）、甲状腺素（T4）、游离甲状腺素（FT4）、促甲状腺激素刺激激素（TSH）等神经内分泌激素水平，并观察研究组治疗前后上述指标变化。结果基线时研究组HAMD总分及各因子分均高于对照组，血清胰岛素、T3、FT3、T4、FT4低于对照组，CORT、ACTH、TSH高于对照组，除T4外其余各项与对照组比较差异均有统计学意义（P〈0．05）；治疗后，研究组HAMD总分及因子分较基线时显著降低，同时CORT、AcTH、TSH较基线时降低，而胰岛素、T3、T4、FT3、FT4较基线时增高，治疗前后比较差异均有统计学意义（P〈0．05）。相关分析发现血清胰岛素同HAMD总分、阻滞、认识障碍负相关；CORT同阻滞正相关；ACTH同HAMD总分、焦虑／躯体化、阻滞正相关；T3同阻滞负相关，FT3同HAMD总分、认识障碍负相关；T4同HAMD总分、焦虑／躯体化负相关；FT4同HAMD总分、阻滞负相关；TSH同阻滞、认识障碍正相关。差异均具有统计学意义（P〈0．05）。结论抑郁症患者存在胰岛素分泌不足、HPA轴功能亢进、HPT轴功能低下等神经内分泌功能失调表现，且与临床症状存在一定的关联性。Objective To investigate changes of serum insulin and neuroendocrine hormones in pa- tients with depression and their correlation with clinical symptoms. Methods A total of 120 depressive patients were assigned to research group and 60 healthy individuals to control group. The clinical symp- toms of patients were evaluated with Hamilton depression scale （HAMD）： Serum insulin, CORT, ACTH, T3, FT3, T4, FT4 and TSH were quantitatively measured. The data from each group were statistically analyzed before and after the treatment. Results Serum insulin, T3, FT3, T4 and FT4 in patients group were significantly lower than those in control group at baseline, while CORT, ACTH, and TSH were significantly higher. After treatment, the scores of HAMD17, CORT, ACTH and TSH in patients group were lower than those before treatment, while serum insulin, T3, T4, FT3 and FT4 were higher than those before treatment. Person correlation analysis on neuroendocrine hormones and HAMD showed that serum insulin was negatively correlated with the HAMD total score, retardation and cognitive disturbance; CORT was positively correlated with retardation. ACTH was also positively cor- related with the HAMD total score, anxiety--body, and retardation. T3 was negatively correlated to re- tardation and FT3 was negatively correlated to HAMD total score and cognitive disturbance. T4 was negatively correlated with the HAMD total score and anxiety--body. FT4 was negatively correlated with HAMD total score and retardation. TSH was positively correlated with retardation and cognitive disturb- ance. The correlations were all statistically significant （P 〈 0.05）. Conclusions There are neuroendo- crine disfunction such as hypoinsulinism, HPA axis hyperthyroidism, and HPT axis hypofunction exist in depressive patients,and they are correlated with clinical symptoms.

关 键 词：抑郁症 胰岛素 神经内分泌 

分 类 号：R541.6[医药卫生—心血管疾病]