抑郁症与焦虑抑郁共病患者应激事件及下丘脑-垂体-肾上腺轴功能的比较  

A controlled study on stress events and HPA-axis function in patients with comorbidity of anxiety and depression

作　　者：高镇松[1] 李宏伟[1] 吴强[1] 黄佩珊[1] 

机构地区：[1]广东省汕头市第四人民医院,515021

出　　处：《中国实用医刊》2016年第17期5-7,共3页Chinese Journal of Practical Medicine

基　　金：广东省医学科研基金项目（A2009648）

摘　　要：目的：探讨抑郁症与焦虑抑郁障碍共病患者的应激事件及下丘脑-垂体-肾上腺（HPA）轴功能和特点及与正常人的差异。方法对37例抑郁症患者（抑郁组）及36例焦虑抑郁共病患者（共病组）评定生活事件量表（LES），于治疗前及治疗4、8周末分别测定24 h 尿17-羟皮质醇、24 h 尿游离皮质酮和早晨8：00血浆皮质醇浓度，然后进行组间比较并与28名正常人（健康组）进行对照。结果抑郁组及共病组发生两种以上应激事件的比例、负性应激事件值和 LES 总值均显著高于健康组（P 〈0.05），抑郁组与共病组间比较差异未见统计学意义（P 〉0.05）。抑郁组与共病组24 h 尿17-羟皮质醇和血浆皮质醇均显著高于健康组（P 〈0.05）；治疗前共病组24 h 尿17-羟皮质醇和血浆皮质醇均显著高于抑郁组（P 〈0.05），治疗4周末和治疗8周末抑郁组与共病组间比较差异未见统计学意义（P 〉0.05）。结论抑郁症与焦虑抑郁障碍共病患者有类似而不同于常人的应激事件经历，在 HPA轴释放功能方面存在差异，需加以关注。Objective To investigate the features of stress events and hypothalamus-pituitary-ad-renal（HPA）axis function in patients with comorbidity of anxiety and depression,and the difference from the healthy. Methods Thirty-seven depression patients（depression group）and 36 patients with comor-bidity of anxiety and depression（comorbidity group）were evaluated with life event scale（LES）and the 24 h urine 17-OH cortisol,24 h urine free corticosterone and plasma cortisol concentration at 8：00 am be-fore and after 4,8 weeks treatment was tested. Then,the data were compared between the two groups and compared with 28 healthy（normal group）. Results The proportion of two or more stressful life e-vents,negative stress values and the total value of LES in depression group and comorbidity group were significantly higher than those in the healthy group（P 〈 0. 05）,but there was no significant difference between the depression group and comorbidity group（P 〉 0. 05）. 24 h urine 17-OH cortisol and plasma cortisol showed significantly higher in the depression group and comorbidity group than those in the healthy group（P 〈 0. 05）. Before treatment,24 h urine 17-OH cortisol and plasma cortisol were signifi-cantly higher in comorbidity group than those in depression group（P 〈 0. 05）. After 4,8 weeks treat-ment,there was no significant difference between the depression group and comorbidity group（ P 〉0. 05）. Conclusions Patients with depression and those with comorbidity of anxiety and depression have similar and different from the normal stress experiences. There are differences of HPA axis release func-tions between the two disorders and need to be concerned about.

关 键 词：抑郁症 焦虑抑郁共病 应激事件 下丘脑-垂体-肾上腺轴疾病 

分 类 号：R749[医药卫生—神经病学与精神病学]