重性抑郁障碍急性期患者血清沉默信息调节因子1、6与草酸艾司西酞普兰片疗效的关系  

Relationship among serum silent information regulators 1,6 and the efficacy of escitalopram oxalate tablets in patients with major depressive disorder in the acute stage

作　　者：陈朝英 苗晓露 李秀芳 孙艳山 王健 CHEN Zhaoying;MIAO Xiaolu;LI Xiufang(Handan Integrated Traditional Chinese and Western Medicine Hospital(Handan Mental Health Center),Handan 056000,China)

机构地区：[1]邯郸市中西医结合医院(邯郸市精神卫生中心),河北邯郸056000

出　　处：《精神医学杂志》2024年第5期492-495,共4页Journal of Psychiatry

基　　金：邯郸市科学技术研究与发展计划项目(编号:23422083179)。

摘　　要：目的分析重性抑郁障碍(MDD)急性期患者血清沉默信息调节因子(SIRT)1、6与草酸艾司西酞普兰片治疗疗效的关系。方法选择179例首发MDD急性期患者,所有研究对象均接受草酸艾司西酞普兰片治疗。治疗12周后,根据疗效分为有效组与无效组。对比无效组与有效组临床资料、血清SIRT1、SIRT6水平,分析MDD急性期患者治疗无效的影响因素,分析血清SIRT1、SIRT6单独及二者联合应用对MDD急性期患者治疗无效的预测价值。结果治疗12周后,MDD急性期草酸艾司西酞普兰片治疗无效率为22.35%。无效组自杀意念、精神疾病家族史占比高于有效组(P<0.05)。无效组血清SIRT1水平低于有效组,血清SIRT6水平高于有效组(P<0.001)。Logistic回归分析结果显示,有精神疾病家族史、血清SIRT6升高为MDD急性期患者治疗无效的独立危险因素(P<0.05),血清SIRT1升高是保护因素(P<0.05)。血清SIRT1、SIRT6单独及二者联合预测MDD急性期患者治疗无效的曲线下面积(AUC)分别为0.797、0.845、0.909,且二者联合预测效能更高。结论血清SIRT1、SIRT6水平可用于预测MDD急性期患者草酸艾司西酞普兰片的治疗疗效,且二者联合具有更高的预测价值。Objective To explore the relationship among serum silent information regulators(SIRTs)1,6 and the efficacy of escitalopram oxalate tablets in patients with major depressive disorder(MDD)in the acute stage.Methods A total of 179 patients with the first-episode MDD in the acute stage were randomly selected and treated with escitalopram oxalate tablets.After 12 weeks of treatment,patients were divided into effective group and ineffective group according to the efficacy of antidepressant drugs.The clinical data,serum SIRT1 and SIRT6 levels were compared between two groups.The influencing factors of treatment ineffectiveness in patients with MDD in the acute stage were analyzed.The predictive values of serum SIRT1,SIRT6 alone or in combination in patients with acute MDD were analyzed.Results After 12 weeks of treatment,the inefficient rate of escitalopram oxalate tablets treatment was 22.35%.The proportions of suicidal ideation and family history of mental disorder in ineffective group were higher than those in effective group(P<0.05).The serum SIRT1 level in ineffective group was lower than that in effective group,and the serum SIRT6 level was higher than that in effective group(P<0.001).Logistic regression analysis showed that family history of mental disorder and elevated serum SIRT6 level were independent risk factors for inefficient treatment in acute MDD(P<0.05),and elevated serum SIRT1 level was a protective factor(P<0.05).The area under the curve(AUC)of serum SIRT1 and SIRT6 alone and combined to predict the efficacy in patients with acute MDD were 0.797,0.845 and 0.909,respectively,and the combined predictive efficacy was the highest.Conclusion Serum SIRT1 and SIRT6 levels can be used to predict the efficacy of escitalopram oxalate tablets in patients with MDD in the acute stage,and the combination of the two has higher predictive value.

关 键 词：重性抑郁障碍急性期 沉默信息调节因子1 沉默信息调节因子6 草酸艾司西酞普兰片 疗效 预测价值 

分 类 号：R749.4[医药卫生—神经病学与精神病学]