抑郁症患者脑脊液单胺代谢产物水平预测自杀的随访研究

Cerebrospinal fluid monoamine metabolites predict the suicidal bebaviors in depressed patients

目的:探讨脑脊液单胺代谢产物对抑郁症患者自杀行为的预测价值。方法:应用高效液相色谱法,测定24例抑郁患者住院时及25例对照组患者脑脊液5-羟吲哚乙酸(5-HIAA)、3-甲基-4-羟苯乙二醇(MHPG)及高香草酸(HVA)的浓度,并对患者的康复情况进行5年后随访。分析抑郁患者本次发作的自杀行为、随访后的自杀行为与脑脊液单胺代谢产物的关系。结果:本次发作自杀组5-HIAA浓度显著低于对照组;本次发作无自杀组MHPG浓度显著低于对照组;本次发作自杀组HVA浓度显著低于对照组;本次发作自杀组HVA浓度显著低于本次发作无自杀组。随访后自杀组5-HIAA浓度显著低于对照组。结论:脑脊液5-HIAA水平低下既与抑郁症患者近期自杀行为有关,也可能是预测抑郁患者远期自杀行为的有效指标。

Objective：To explore the Predictor of cerebrospinal fluid monoamine metabolites in depressed inpatients with suicidal Bebaviors. Methods：Twenty-four patients with major depression and 25 controls were enrolled in the study. The CSF concentrations of 5-hydroxyindoleacetic acid （5-HIAA）,norepinephrine （NE） metabolites 3-methoxy-4-hydroxyphenylglycol（MHPG） and dopamine （DA） metabolites homovanillic acid （HVA） were measured by high-pressure liquid chromatography. Twenty-four depressed patients were followed up in 5 years. The relationship between CSF monoamine metabolites and present suicidal behaviours（suicidal group and non-suicidal group） or suicidal behaviours followed up （suicidal group and non-suicidal group）. Results：CSF 5-HIAA levels in suicidal group this time were significantly lower than those in control group. CSF MHPG levels in non-suicidal group this time were significantly lower than those in control group. CSF HVA levels in suicidal group this time were significantly lower than those in control goup. CSF HVA levels in suicidal group this time were significantly lower than those in non-suicidal group this time. CSF 5-HIAA levels in suicidal group followed up were significantly lower than those in control group. Conclusion：h is suggested that 5-HIAA is associated with suicidal behaviors. In depressed patients,5-HIAA perhaps can predict the suicidal behaviors.