血清皮质醇水平在阿尔茨海默病与抑郁障碍鉴别中的作用  

Role of serum cortisol level in differentiating Alzheimer disease from depression

作　　者：陈峰 吕永良[1] Chen Feng;Lyu Yongliang(Department of Geriatric Psychiatry,Suzhou Guangji Hospital,Suzhou 215137,China)

机构地区：[1]苏州市广济医院老年精神科,215137

出　　处：《神经疾病与精神卫生》2021年第10期710-714,共5页Journal of Neuroscience and Mental Health

摘　　要：目的探讨血清皮质醇水平在鉴别阿尔茨海默病与老年抑郁障碍中的作用.方法回顾性分析苏州市广济医院老年精神科2018年1月1日至2020年10月1日期间住院,年龄55-95岁,且依据ICD-10诊断标准出院诊断为抑郁障碍和阿尔茨海默病的患者的血清皮质醇水平以及雌二醇、生长激素等激素水平资料.结果研究共纳入抑郁障碍患者109例,阿尔茨海默病57例,抑郁障碍组的皮质醇水平明显高于阿尔茨海默病组[478.10(389.81,587.63)nmol/L比370.30(290.66,405.35)nmol/L,Z=5.91,P<0.01],而年龄[(69.68±8.01)岁比(75.77±8.01)岁,t=4.66,P=0.00]、黄体生成素[18.90(9.59,27.60)IU/L比24.31(15.18,34.06)IU/L,Z=2.27,P=0.02]和生长激素[0.23(0.10,0.73)ng/ml比0.30(0.20,1.45)ng/ml,Z=2.02,P=0.04]显著低于阿尔茨海默病组.经过Logistic回归筛选出年龄(OR=0.92,95%CI=0.88-0.96,P<0.01)、皮质醇(OR=1.01,95%CI=1.00-1.01,P<0.01)两项指标构建回归方程.年龄、皮质醇及年龄与皮质醇联合后的ROC曲线下面积分别为0.69(95%CI=0.62-0.76)、0.78(95%CI=0.71-0.84)和0.82(95%CI=0.75-0.88).结论血清皮质醇水平可能可以作为鉴别住院老年抑郁障碍和阿尔茨海默病患者的重要指标.Objective To explore the role of serum cortisol level in differentiating Alzheimer disease(AD)from senile depression.Methods The serum cortisol level,estradiol,growth hormone and other hormone levels of patients aged from 55 to 95 who were diagnosed as depressive disorder or AD according to ICD-10 diagnostic criteria and discharged from the Department of Geriatric Psychiatry,Suzhou Guangji Hospital from January 1,2018 to October 1,2020 were analyzed retrospectively.Results A total of 109 patients with depression and 57 patients with AD were included in the study.The cortisol level in depression group was significantly higher than that in AD group[478.10(389.81,587.63)nmol/L vs 370.30(290.66,405.35)nmol/L;Z=5.91,P<0.01],while the age[(69.68±8.01)vs(75.77±8.01);t=4.66,P<0.01],luteinizing hormone[18.90(9.59,27.60)IU/L vs 24.31(15.18,34.06)IU/L;Z=2.27,P=0.02]and growth hormone[0.23(0.10,0.73)ng/ml vs 0.30(0.20,1.45)ng/ml;Z=2.02,P=0.04]were significantly lower than those in AD group.Two indexes,age(0R=0.92,95%CI:0.88-0.96,P<0.01)and cortisol(0R=1.01,95%CI:1.00-1.01,P<0.01),were selected by logistic regression to construct regression equation.The area under ROC curve of age,cortisol and the combination of age and cortisol were 0.69(95%CI:0.62-0.76),0.78(95%CI:0.71-0.84)and 0.82(95%CI:0.75-0.88),respectively.Conclusions Semm cortisol level may be used as an important index to differentiate senile depression from AD in hospital.

关 键 词：皮质醇 阿尔茨海默病 老年抑郁障碍 鉴别诊断 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]