难治性抑郁症与HPA轴的关系研究

Study on the Relationship Between HPA Axis and Treatment-Resistant Depression

目的探讨难治性抑郁症患者的神经内分泌特点。方法以符合CCMD-3"抑郁症"诊断标准,且符合"难治性抑郁症"标准的60例患者为研究组,以43健康者为对照组。完成一般情况问卷和HAMD-17评定后,患者接受药物或针刺治疗,总疗程14周,并检测患者促肾上腺皮质激素(ACTH)和皮质醇(CORT)。结果难治性抑郁症患者血浆ACTH和血清CORT均高于正常对照;与治疗前相比,治疗后患者ACTH和CORT水平明显下降(P<0.01);ACTH和CORT与患者HAMD评分呈正相关。结论难治性抑郁症患者存在HPA轴的功能亢进,且HPA轴功能改变可作为治疗的预判指标及疾病严重程度的生物学指标。

Objective To explore the characteristics of neuroendocrine in patients with treatment-resistant depression （TRD）. Methods Sixty TRD patients and 43 healthy people were enrolled. All of them completed the common questionnaire and HAMD-17. The patients received the treatment of drugs or acupuncture. The concentration of ACTH and cortisol were detected at pretreatment and posttreatment. Results The concentration of ACTH and cortisol in patient group were higher than that of the healthy group （P 〈0.01）. At the 14~ weekend, the concentration of ACTH and cortisol in patient group were significantly lower than that of pretreatment. There was significant positive correlation between ACTH, CORT and the scores of-.~HAMD. Conclusions The patients with treatment-resistant depression have HPA hyperfunction; the function of HPA can be served as the pr~＇dictable indicator of the treatment and the biomarker of the disease＇s severity.