血清Hcy、25(OH)D含量预测抑郁症患者重复经颅磁刺激干预疗效的价值  

Value of serum Hcy and 25(OH)D levels in predicting the efficacy of repeated transcranial magnetic stimulation intervention in patients with depression

作　　者：刘玉红[1] 郭文利 戈建描 李洁 马飞 LIU Yu-hong;GUO Wen-li;GE Jian-miao(Department of Comprehensive Treatment,2 Department of Clinical Psychotherapy Center,The Inner Mongolia Autonomous Region Mental Health Center(The Third Hospital of the Inner Mongolia Autonomous Region,the Inner Mongolia Autonomous Region Brain Hospital),Hohhot Inner Mongolia 010000,China)

机构地区：[1]内蒙古自治区精神卫生中心(内蒙古自治区第三医院内蒙古自治区脑科医院)综合治疗科,内蒙古呼和浩特010000 [2]内蒙古自治区精神卫生中心(内蒙古自治区第三医院内蒙古自治区脑科医院)临床心理治疗中心,内蒙古呼和浩特010000

出　　处：《临床和实验医学杂志》2024年第24期2658-2661,共4页Journal of Clinical and Experimental Medicine

基　　金：内蒙古自治区卫生健康委项目(编号:2023GLLH0156)。

摘　　要：目的探讨血清同型半胱氨酸(Hcy)、25羟基维生素D[25(OH)D]含量预测抑郁症患者重复经颅磁刺激(rTMS)干预疗效的价值。方法回顾性分析2022年1月至2024年3月内蒙古自治区精神卫生中心收治的82例抑郁症患者的临床资料。所有患者均行重复经颅磁刺激(rTMS)治疗,治疗后1个月使用汉密尔顿抑郁量表(HAMD)评估两组抑郁症状,根据评分结果分为疗效不良组(n=20)与疗效良好组(n=62)。比较两组一般资料[性别、年龄、体重指数、病程、婚姻状况、文化程度、精神病家族史及匹兹堡睡眠质量指数(PSQI)评分]以及血清25(OH)D、Hcy水平。通过多因素Logistic回归分析明确抑郁症患者rTMS干预后疗效不良的危险因素,通过受试者操作特征(ROC)曲线分析PSQI评分、血清Hcy、25(OH)D水平预测抑郁症患者rTMS干预后疗效不良的价值。结果两组性别、年龄、体重指数、病程、婚姻状况、文化程度、精神病家族史比较,差异均无统计学意义(P>0.05);疗效不良组PSQI评分、血清Hcy水平分别为(10.61±2.23)分、(20.82±3.12)μmol/L,均高于疗效良好组[(6.11±0.29)分、(13.14±2.54)μmol/L],血清25(OH)D水平为(24.46±2.13)ng/mL,低于疗效良好组[(35.74±3.65)ng/mL],差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,PSQI评分、血清Hcy、25(OH)D水平均是抑郁症患者rTMS干预后疗效不良的危险因素(P<0.05)。经ROC曲线分析证实,PSQI评分、血清Hcy、25(OH)D水平均可用于抑郁症患者rTMS干预疗效不良的预测,曲线下面积分别为0.794、0.773、0.756,均有P<0.05。结论抑郁症患者rTMS干预后疗效不良受PSQI评分、血清Hcy、25(OH)D水平影响,在该疾病治疗期间临床医师应密切监测上述指标。Objective To explore the value of serum homocysteine(Hcy)and 25 hydroxyvitamin D[25(OH)D]levels in predicting the efficacy of repeated transcranial magnetic stimulation(rTMS)intervention in patients with depression.Methods A retrospective analysis was conducted on the clinical data of 82 patients with depression admitted to the Inner Mongolia Autonomous Region Mental Health Center from January 2022 to March 2024.All patients underwent rTMS treatment,and one month after treatment,the Hamilton depression rating scale(HAMD)was used to evaluate the depressive symptoms of the two groups.According to the scoring results,the patients were divided into the poor efficacy group(n=20)and the good efficacy group(n=62).The general information[gender,age,body mass index,course of illness,marital status,education level,family history of mental illness,and Pittsburgh sleep quality index(PSQI)score],as well as serum 25(OH)D and Hcy levels of two groups were compared.By using multivariate Logistic regression analysis,the risk factors for poor efficacy of rTMS intervention in depression patients were identified.Finally,the value of PSQI score,serum Hcy,and 25(OH)D levels for predicting poor efficacy of rTMS intervention in depression patients was analyzed through receiver operating characteristic(ROC)curve.Results There was no statistically significant difference in gender,age,body mass index,disease course,marital status,educational level,and family history of mental illness between the two groups(P>0.05).The PSQI score and serum Hcy level in the poor efficacy group were(10.61±2.23)points and(20.82±3.12)μmol/L,respectively,which were higher than those in the good efficacy group[(6.11±0.29)points and(13.14±2.54)μmol/L],the level of serum 25(OH)D was(24.46±2.13)ng/mL,which was lower than that in the good efficacy group[(35.74±3.65)ng/mL],and the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that PSQI score,serum Hcy,and 25(OH)D levels were risk factors for

关 键 词：抑郁症 经颅磁刺激 同型半胱氨酸 25羟基维生素D 疗效 

分 类 号：R74[医药卫生—神经病学与精神病学]