抑郁症患者血液同型半胱氨酸和叶酸水平的研究

Relationship of Homocysteine and Folic with Depression Abstract

目的研究血浆同型半胱氨酸(Hcy)和血清叶酸水平与抑郁症的关系;并研究抑郁症患者治疗前后血浆同型半胱氨酸(Hcy)和血清叶酸水平的变化。方法采用电化学发光技术检测30例抑郁症患者(符合DSM-Ⅳ重性抑郁症诊断标准)治疗前、治疗4周、6周和健康对照组的血清叶酸水平;采用小分子捕获技术,循环酶法测血浆Hcy。比较患者组治疗前和对照组血液叶酸、Hcy水平,分析Hcy与抑郁程度的关系。比较HAMD减分率>50%的患者治疗前后血浆Hcy水平的变化。统计方法用t检验,χ2检验,方差分析,相关回归分析。结果患者组治疗前叶酸水平为(7.46±1.69)μg/L,与对照组(7.67±2.44)μg/L无显著差异(t=0.632,p=0.534)。患者组治疗前Hcy水平(19.03±7.42)μmol/L显著高于对照组(9.60±3.43)μmol/L(t=6.885,p=0.000)。患者组治疗前高同型半胱氨酸血症(HHcy)发生率显著高于对照组(66.7%比10%,p=0.000)。6周达临床缓解的患者血浆Hcy水平16.24±5.63较治疗前明显下降(t=2.801,p=0.013)。血浆Hcy水平与抑郁程度正相关(r=0.430,p=0.018)。结论本研究样本抑郁症住院患者血浆Hcy水平及HHcy发生率显著高于正常对照组;抑郁症患者血浆中Hcy水平与其抑郁程度呈正相关,随着病情好转其血浆中Hcy水平下降。

Objective The Objective was to study the relationship of homoeysteine and folic levels with depression in pretherapy and post - treatment. Methods The study population was divided into two groups： （a）30 inpatients with DSM- Ⅳ major depressive disorder and （b） 30 healthy controls. All participants were clinically evaluated and completed a questionnaire for clinical data and the 17 - item Hamilton Depression Rating Scale. Measurements of folate and homocysteine were estimated in all blood samples. Serum folate and plasma homoeysteine levels were determined in 30 inpatients at baseline and again on 4 - 6 week follow - up. The 17 - item Hamilton Depression Rating Scale was also evaluated. In the statistical analysis we used Pearson＇s correlation coefficient, the Student＇s t- test, Chi - square Test, analysis of variance, and results were statistically evaluated at P 〈 0.05 level of significance. Results The serum level of folic in control group （7.67 ±2.44 μg/L） and inpatient group before treatment （7.46 ± 1.69μg/L） have not distinction （ t = 0.632, p = 0.534） .The plasma level of Homoeysteine was significantly higher in depressed individuals （19.03 ± 7. 42 μmol/L） than in controls （9.60±3.43 μmol/L） （ t = 6. 885, p = 0.000）. Hyperhomocysteinemia was significantly higher in depressed individuals than in controls （66.7%/10%, p = 0.000）. After 6 - week treatment, the plasma level of Hey in the part of inpatient that have healed （ 16.24 ± 5.63） significantly lower than before treatment （ t = 2. 801, p = 0.013）. Higher levels of plasma homoeysteine are associated with depression individuals （ r = 0.430, p = 0.018）. Conclusion There were significant higher serum levels of homoeysteine and higher rate of HI-Icy in the patients with depressive disorder than the normal control. Higher levels of plasma homoeysteine are associated with depression and the scores of the 17 - item Hamilton Depression Rating Scale. Lower levels of serum folate are not the etiological factor to depression.