老年抑郁症血浆肾素、血管紧张素Ⅱ与醛固酮研究

Study on renin-angiontensin Ⅱ-aldosterone in the elderly depression

目的:探讨老年抑郁症患者血浆肾素、血浆血管紧张素Ⅱ、醛固酮水平的变化及其与抑郁症的关系。方法:调查22例老年单相抑郁症的住院患者(抑郁症组),应用选择性5-羟色胺回收抑制剂(SSRI)药物西酞普兰治疗6周。采用放射免疫法分别于治疗前和治疗第6周末,测定患者血浆肾素、血浆血管紧张素Ⅱ与醛固酮的含量;以汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)每2周评定1次症状的严重程度。以20名健康志愿者为对照组。结果:抑郁症组患者治疗前血浆血管紧张素Ⅱ水平显著高于对照组,血浆肾素水平与血浆醛固酮水平均明显低于对照组。治疗后血浆血管紧张素Ⅱ水平较治疗前明显下降,而血浆肾素、血浆醛固酮水平却无明显变化;治疗前后血浆血管紧张素Ⅱ水平的降低与HAMD和HAMA的减分率呈显著负相关;而治疗前后血浆肾素、血浆醛固酮水平的变化与HAMD和HAMA减分率无明显相关关系。结论:老年抑郁症患者的肾素-血管紧张素Ⅱ-醛固酮之间存在紊乱的现象;血管紧张素Ⅱ与老年抑郁的关系尤其密切,血管紧张素Ⅱ可能参与了老年抑郁症的病理生理过程。

Objective;To explore the change of plasma renin-angiontensin Ⅱ-aldosterone in patients with the elderly depression, and the relationship between renin-angiontensin Ⅱ -aldostemne and depressive. Method： 22 elderly depressed patients were recruited and treated with citaloprarn for 6 weeks, and twenty healthy volunteers were recruited as controls, The plasma renin-angiontensin Ⅱ -aldosterone was measured by radioimmunoassay before and after treatment. The severity of symptom was evaluated with the Hamilton rating scale for depression （HAMD）, and the Hamilton rating scale for anxiety （HAMA） .20 healthy people constituted the controlled group. Results：The plasma angiotensin Ⅱ level was significantly higher in patients before treatment than that in controls, the plasma renin and aldosterone level significantly decreased in patients than that in controls, the plasma angiotensin Ⅱ level significantly decreased after treatment, the plasma renin and aldosterone showed no change. There was significant negative correlation between the reduction of plasma angiotensin Ⅱ and the reduction rate of HAMD and HAMA score. No significant correlation between the changes of the plasma retain, as well as the changes of plasma aldosterone, and the reduction rate of HAMD or HAMA score was observed. There was no significant correlation among the changes of the plasma renin-angiontensin Ⅱ- aldostemne in the eldedy depression. Conclusion： There are eonfusional phenomena among the changes of the plasma renin-angiontensin Ⅱ -aldosterone in the elderly depression. The angiotensin Ⅱ might be involved in pathophysiology of the eldly depression.