内源性和非内源性抑郁症自杀患者脂质及脂蛋白水平研究

Analysis of suicidal behavior and detection of biological parameter in patients with depressive disorder

目的分析有自杀行为的抑郁症患者不同诊断类别的差异,并探求其脂质及脂蛋白的差异。方法对66抑郁症患者的自杀行为进行分析,并采用酶法、免疫比浊法检测66例抑郁症和36名健康对照者的血清胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白AI(apoAI)、载脂蛋白B(apoB)水平。结果①66例抑郁症患者中有自杀行为的25例,占37.9%(25/66),且无性别差异(χ2=0.93,P>0.05=0.7607);自杀行为组中内源性抑郁症患者所占比例高于无自杀行为组,两者比较有统计学差异(χ2=4.379,P<0.05=0.036),拟然比(LR)=4.454,P<0.05=0.035。②有自杀行为的抑郁症患者者,无论是内源性还是非内源性抑郁症患者,TC浓度均低于对照组(P<0.001),不同亚组患者间无统计学差异(P>0.05)。③有自杀行为的内源性抑郁症患者TC亚组分HDL-C以及apoAI分别低于非内源性患者和对照组(P<0.001),非内源性患者TC亚组分LDL-C低于对照组(P<0.05)。结论内源性抑郁症患者发生自杀行为的可能性高于非内源性抑郁症患者,且无性别差异;低胆固醇水平可能是抑郁症自杀患者共同的生物学标志之一,其亚组分HDL-C水平减低,可能是内源性抑郁症自杀患者特有的生物学标志。

Objective To analyze the different diagnosis category of suicidal behavior and explore the change of biological parameter of lipids and protein in depression.Methods Suicidal behavior was analyzed in 66 patients with depressive disorder,serum levels of total cholesterol（TC）,triglycerides（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,apolipoprotein AI（apoAI）,apolipoprotein B（apoB） were measured in 66 patients with depressive disorder and 36 healthy controls using enzymatic methods and immunoturdidimetry.Results ①Totally 25 patients were depressive disorder with suicidal behavior,about 37.9%（25/66）,Male and female no significant differences（χ2=2.188,P0.05=0.139）;The proportion of endogenous depression in suicidal behavior group was higher than in non-suicidal behavior group,significant difference was found（P0.05）,likelihood ratio（LR）=4.454（P0.05）.②Patients with suicidal behavior no matter endogenous depression or non-endogenous depression,TC concentration were all lower than those the controls（P0.001）.Different subgroups among patients were not statistically difference（P0.05）.③Endogenous depressive patients with suicidal behavior TC subgroup element HDL-C and apoAI element were respectively lower than that of endogenous depressive patients and control group（P0.001）,non-endogenous depressive patients TC subgroup element HDL-C were lower than those the controls（P0.05）.Conclusions These results suggest that the likelihood of suicidal behavior is higher in endogenous depression than in non-endogenous depression;Male and female no significant differences;Low cholesterol may be one of the common symbols of biology of the depressive patients with suicidal behavior,the subgroup element HDL-C reducing may be the typical biology symbol of endogenous depressive patients with suicidal behavior.