Hcy、叶酸及心肌酶水平在酒依赖伴抑郁症患者中的水平变化及临床意义  

Changes and clinical significance of homocysteine,folate,and cardiac enzyme levels in patients with alcohol dependence and depression

作　　者：徐陈骐 汤锦磊 林蒙蜜 翁晓璐 Xu Chenqi;Tang Jinlei;Lin Mengmi;Weng Xiaolu(Department of Laboratory Medicine,Wenzhou Seventh People's Hospital,Wenzhou 325000,Zhejiang Province,China;Department of Behavioral Medicine,Wenzhou Seventh People's Hospital,Wenzhou 325000,Zhejiang Province,China;Department of Endocrinology,The 2nd Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang Province,China)

机构地区：[1]温州市第七人民医院检验科,温州325000 [2]温州市第七人民医院行为医学科,温州325000 [3]温州医科大学附属第二医院内分泌科,温州325027

出　　处：《中国基层医药》2024年第8期1126-1132,共7页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省温州市科技计划(Y2020449)。

摘　　要：目的:分析同型半胱氨酸(Hcy)、叶酸及心肌酶水平在酒依赖伴抑郁症患者中的水平变化及临床意义。方法:选取2022年1月至2023年6月在温州市第七人民医院收治的酒依赖伴抑郁症患者102例为观察组。使用密西根酒依赖筛查表(MAST)对观察组患者的酒依赖程度进行评价,将其分为轻度酒依赖组(33例)、中度酒依赖组(37例)、较重酒依赖组(15例)、严重酒依赖组(17例)。使用汉密尔顿抑郁症评定量表(HAMD)对观察组患者的疾病严重程度进行评价,将其分为轻度抑郁组(43例)、中度抑郁组(34例)、重度抑郁组(25例)。采用蒙特利尔认知评估量表(MoCA)评估观察组患者认知功能,将其分为认知功能正常组(73例)、认知功能障碍组(29例)。并选择同一时期该院30例健康志愿者为对照组。比较各组Hcy、叶酸及心肌酶水平。并采用Pearson法分析Hcy、叶酸及心肌酶水平与HAMD、MoCA、MAST评分的相关性。结果:观察组Hcy水平为(15.21±1.99)μg/L,显著高于对照组的(11.38±1.46)μg/L(t=-9.80,P<0.001),叶酸、乳酸脱氢酶(LDH)及肌酸激酶(CK)水平分别为(4.82±1.77)μg/L、(122.69±33.98)IU/L、(87.83±16.52)IU/L,均显著低于对照组的(6.27±1.35)μg/L、(150.56±38.78)IU/L、(98.67±20.29)IU/L(t=4.16、3.82、2.99,均P<0.05)。轻度、中度、较重及严重酒依赖组Hcy水平[(13.16±1.23)μg/L、(15.35±0.82)μg/L、(16.79±1.38)μg/L、(17.63±1.22)μg/L]依次升高,叶酸[(6.11±1.51)μg/L、(4.95±1.40)μg/L、(4.04±0.99)μg/L、(2.70±0.99)μg/L]、LDH[(153.35±27.47)IU/L、(123.29±16.59)IU/L、(109.83±14.41)IU/L、(73.24±16.86)IU/L]及CK水平[(104.14±12.78)IU/L、(86.48±9.15)IU/L、(78.11±7.85)IU/L、(67.71±9.00)IU/L]依次降低,差异均有统计学意义(F=73.24、26.53、59.08、53.86,均P<0.001)。轻度、中度及重度抑郁组Hcy水平[(13.75±1.54)μg/L、(15.46±1.17)μg/L、(17.39±1.31)μg/L]依次升高,叶酸[(5.83±1.77)μg/L、(4.67±1.12)μg/L、(3.28±1.26)μg/L]、Objective To analyze the changes and clinical significance of homocysteine(Hcy),folate,and cardiac enzyme levels in patients with alcohol dependence and depression.Methods A total of 102 patients with alcohol dependence and depression,who received treatment at Wenzhou Seventh People's Hospital from January 2022 to June 2023,were included in the observation group.The degree of alcohol dependence in patients in the observation group was assessed using the Michigan Alcoholism Screening Test(MAST).According to the assessment results,the patients in the observation group were divided into the following subgroups:mild alcohol dependence(n=33),moderate alcohol dependence(n=37),heavy alcohol dependence(n=15),and severe alcohol dependence(n=17).The severity of depression among patients in the observation group was assessed with the Hamilton Depression Scale(HAMD).Based on the assessment results,the patients in the observation group were divided into the following subgroups:mild depression(n=43),moderate depression(n=34),and severe depression(n=25).The cognitive function of patients in the observation group was assessed using the Montreal Cognitive Assessment Scale(MoCA).According to the assessment results,the patients in the observation group were divided into normal cognitive function(n=73)and cognitive impairment(n=29)subgroups.Thirty healthy volunteers from our hospital during the same period were included in the control group.The levels of Hcy,folate,and cardiac enzymes were compared among all groups.The correlations between Hcy,folate,and cardiac enzyme levels with HAMD,MoCA,and MAST scores were analyzed using the Pearson method.Results The Hcy level in the observation group was(15.21±1.99)μg/L,which was significantly higher than that in the control group[(11.38±1.46)μg/L,t=-9.80,P<0.001].The levels of folate,lactate dehydrogenase(LDH),and creatine kinase(CK)in the observation group were(4.82±1.77)μg/L,(122.69±33.98)IU/L,and(87.83±16.52)IU/L,respectively,which were significantly lower than those in the contro

关 键 词：抑郁症 精神病 酒精中毒性 半胱氨酸 叶酸 L-乳酸脱氢酶 肌酸激酶 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R749.62[医药卫生—临床医学]