抑郁症患者脑小血管病共患率及相关因素  

Comorbidity rate of cerebral small vessel disease in patients with depression and its related factors

作　　者：康岚[1] 王晓霞[2] 陈红光[1] 宋煜青[1] 林凯[1] 张函 刘颖[4] 王希林[1] KANG Lan;WANG Xiaoxia;CHEN Hongguang;SONG Yuqing;LIN Kai;ZHANG Han;LIU Ying;WANG Xilin(Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Heath(Peking U-niversity),National Clinical Research Center for Mental Disorders(Peking Uni vesity Sixth Hospital),Beijing 100083,China;The Fourth Hospital of Baotou,Baotou 014030,Inner Mongolia Autonomous Region,China;Beijing Huaxin Hospital(the First Hospital of Tsinghua University),Beijing 100015,China;Peking Univesity Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083 [2]内蒙古包头市第四医院,内蒙古包头014030 [3]北京华信医院(清华大学第一附属医院),北京100015 [4]北京大学第三医院,北京100191

出　　处：《中国心理卫生杂志》2023年第5期361-366,共6页Chinese Mental Health Journal

基　　金：科技部国家科技支撑计划(2009BA77B00)

摘　　要：目的:了解抑郁症患者脑小血管病的患病情况,探讨抑郁症与脑小血管病的关联性,为早期防治提供依据。方法:纳入病情稳定且符合疾病及有关健康问题的国际统计分类第十次修订本(ICD-10)抑郁发作和复发性抑郁障碍诊断标准的患者80例,正常对照97例,采用蒙特利尔认知评估量表(Mo-CA)、简明精神状况测查(MMSE)、汉密顿抑郁量表、汉密顿焦虑量表测评两组被试的认知功能和情绪状态,并收集相关病史资料。用头颅磁共振成像(MRI)数据评估脑小血管病阳性检出率和MRI诊断特征,采用logistic回归分析抑郁症与脑小血管病的关联关系。结果:抑郁症组与正常对照组年龄分别为(59±9)岁和(58±8)岁(P>0.05)。抑郁症组有高血压病史者比例高于正常对照组,MoCA总分低于正常对照组(均P<0.05)。抑郁症组符合脑小血管病诊断者比例高于正常对照组(83.8%vs.64.9%,P<0.01)。Logistic回归结果显示腔隙性脑梗死(OR=4.4,95%CI:1.07~18.23)、额叶脱髓鞘(OR=2.4,95%CI:1.05~5.42)及MoCA<26分(OR=2.3,95%CI:1.16~4.47)是抑郁症的危险因素。结论:共患脑小血管病在中老年抑郁症患者中较常见,腔隙性脑梗死和额叶脱髓鞘可能是中老年抑郁的危险因素。Objective:To explore the correlation between depression and comorbidity of cerebral small vessel disease(CSVD)in patients with depression,so as to provide evidence for early prevention and treatment Methods:Totally 80 patients with stable depressive episode and recurrent depressive disorder according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision(ICD-10),as well as 97 normal controls were included.Medical history was collected,and cognitive function and mental status were assessed using Montreal Cognitive Assessment MoCA),Mini-Mental State Examination MMSE),Hamilton Depression Scale and Hamilton Anxiety Scale.Positive rate of CSVD diagnosis and the relevant magnetic resonance imaging(MRI)diag­nostic features were evaluated by cranial MRL Logistic regression analysis was used to analyze the correlation be­tween depression and CSVD.Results:The age of depression group and normal control group were(59±9)years and(58±8)years,respectively(P>0.05).Higher proportion of hypertension and lower MoCA total scores were seen in the depression group than in the normal control group(Ps<0.05).The proportion of CSVD was higher in the depression group than in the normal control group(83.8%vs.64.9%,P<0.01).Logistic regression analysis showed that lacunar cerebral infarction(OR=4.4,95%Cl:1.07-18.23),frontal lobe demy eh nation(OR=2.4.95%Cl:1.05-5.42)and MoCA<26(OR=2.3,95%Cl:1.16-4.47)were the risk factors of depression.Conclusion:Co morbid CSVD is common in the middle-aged and elderly patients with depression,for whom lacunar cerebral infarction and frontal lobe demyelination maybe the risk factors.

关 键 词：抑郁症 脑小血管病 危险因素 中老年 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]