肠易激综合征患者精神状态与脑电图改变的相关性研究  

The correlation between the state of depression and anxiety and the change of EEG in IBS patients

作　　者：金玉[1] 谭诗云[1] 

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2014年第4期463-467,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨肠易激综合征(irritable bowel syndrome,IBS)不同类型患者与焦虑和抑郁之间相关性及与脑电图、血小板5-HT水平之间的关系。方法对92例IBS患者独立完成调查问卷(其中D-IBS 32例、C-IBS 31例、A-IBS 29例),包括焦虑自评量表(self-rating anxiety scale,SAS)、ZUNG氏抑郁量表(self-rating depression scale,SDS),并两个半小时脑电图,第一个半小时为适应检查,第二个半小时为正式检查,在未进行任何治疗前,对IBS患者和正常对照组均于上午9时空腹抽取静脉血2 ml,缓慢注入经硅油涂布的含5%依地酸钠0.15 ml抗凝试管中摇匀,测定血小板5-HT。结果 (1)IBS(C-IBS、D-IBS、A-IBS)组中SDS分数>50分,表明患者表现出一定的抑郁症状,其中C-IBS组EEG异常占93.55%;D-IBS组EEG异常占84.38%;A-IBS组EEG异常占89.66%。IBS(C-IBS、D-IBS、A-IBS)组中SAS分数>50分,表明患者表现出一定的焦虑症状,其中C-IBS组EEG异常占70.97%;D-IBS组EEG异常占78.13%;A-IBS组EEG异常占72.41%。SAS、SDS分数>50分者与IBS有相关性;(2)C-IBS、D-IBS、A-IBS组的血小板5-HT水平(μg/109)分别为(142.71±31.52)、(141.62±33.09)、(145.10±30.28),均明显低于对照组的平均血小板5-HT水平(323.87±39.45),且差异具有显著统计学意义(P<0.05)。C-IBS、D-IBS、A-IBS三组之间血小板5-HT表达水平无显著统计学意义(P>0.05)。IBS组患者的血小板5-HT浓度明显降低,而且IBS各组合并抑郁症患者血小板5-HT浓度降低更明显,IBS组血小板5-HT水平与SDS评分呈正相关(r=0.428,P<0.05)。结论部分IBS患者合并焦虑和抑郁负性情绪,患者的脑电图检查异常有显著性;IBS组患者血小板5-HT浓度明显降低。Objective To explore the correlation among the subgroups of IBS, anxiety, depression, EEG and plate- let 5-HT levels. Methods 92 patients with IBS （including 32 cases of D-IBS, 31 cases of C-IBS and 29 cases of A- IBS） were collected to attend the clinic to be interviewed and complete a questionnaire for self-rating scale which include anxiety rating scale （ self-rating anxiety scale, SAS） , ZUNG＇ s depression scale （ self-rating depression scale, SDS）. Twice EEG examinations were carried out to the all cases, and half an hour each time. The first time was the preliminary examination ; the second time was the final examination. The platelet 5-HT content of blood samples of all cases and nor- mal control group were analyzed. Results （ 1 ） The SDS score 〉 50 points in IBS （ C-IBS, D-IBS, A-IBS） group indi- cated that the patients showed some symptoms of depression, including EEG abnormalities accounted for 93.55% in C- IBS group; EEG abnormalities accounted for 84.38% in D-IBS group; EEG abnormalities accounted for 89.66% in A- IBS group. SAS score 〉 50 points in IBS （ C-IBS, D-IBS, A-IBS） group indicated that the patients showned some anxie- ty symptoms, including EEG abnormalities accounted for 70.97% in C-IBS group; EEG abnormalities accounted for 78. 13% in D-IBS group and 72.41% in A-IBS group. SAS, SDS scores 〉50 points with IBS relevance. （2） Platelet 5- HT levels （μg/109） were （142.71 ±31.52）, （141.62 ±33.09） and （145.10 ±30.28） in C-IBS, D-IBS and A-IBS group, significantly lower than the control group （323.87 ± 39.45 ） , and the difference was statistically significant （ P 〈 O. 05）. Platelet 5-HT expression level in C-IBS, D-IBS, A-IBS group was not statistically significant （P 〉 0.05）. Platelet 5-HT concentration was significantly lower in IBS group, platelet 5-HT concentrations reduced more obvious in each IBS group combined depression, platelet 5-HT level and SDS score was positive related （ r = 0. 428, P 〈 0.05 ）. Conclusio

关 键 词：肠易激综合征 焦虑 抑郁 脑电图 血小板5-HT 

分 类 号：R574.4[医药卫生—消化系统]