抑郁症患者脑脊液生长抑素及单胺代谢产物浓度与临床症状的关系

Cerebrospinal fluid Levels of somatostatin and monoamine metabolites correlated with symptoms of patients with depression

目的 探讨抑郁症患者脑脊液生长抑素 (SS)和单胺代谢产物浓度与临床症状的关系 ,以及神经递质之间的相互作用。方法 应用放射免疫测定法和高效液相色谱法 ,测定 2 3例抑郁症患者脑脊液SS和 5 羟色胺 (5 HT)代谢产物 5 羟吲哚乙酸 (5 HIAA)、去甲肾上腺素 (NE)代谢产物 3 甲基 4 羟 苯乙二醇 (MHPG)及多巴胺 (DA)代谢产物高香草酸 (HVA)的浓度。临床症状评估采用汉密尔顿抑郁量表 (HAMD)因子分析。结果 抑郁症患者HAMD的焦虑 /躯体化因子在脑脊液HVA浓度7 7～ 17 7ng/L ,18 2～ 2 6 5ng/L ,2 9 2～ 78 6ng/L的得分分别为 (1 6± 0 4)分、(1 5± 0 4)分和 (2 2±0 3)分 ,差异有非常显著性 (P <0 0 1) ,且 5 HIAA与HVA之间存在交互作用 (P <0 0 5 ) ;迟缓因子在SS 7 7～ 12 2ng/L ,15 8～ 2 1 2ng/L ,2 1 5～ 40 7ng/L的得分分别为 (2 5± 0 6 )分、(2 2± 0 6 )分和(1 7± 0 5 )分 (P <0 0 1) ,在MHPG 8 0～ 30 4ng/L ,33 1～ 74 0ng/L ,81 2～ 147 8ng/L的得分分别为(2 4± 0 4)分、(2 1± 0 8)分和 (1 8± 0 6 )分 (P <0 0 5 ) ,在HVA上述 3个浓度的得分分别为 (1 8±0 5 )分、(2 1± 0 6 )分和 (2 5± 0 6 )分 (P <0 0 1) ,且SS与 5 HIAA之间存在交互作用

Objective The purpose of this study was to explore the relationship between cerebrospinal fluid (CSF) somatostatin and monoamine metabolites and the clinical symptoms in patients with major depression Methods Twenty three patients with major depression were enrolled in the study The depressive symptoms were assessed with the 24 items Hamilton Depression Scale (HAMD) The CSF concentration of SS was measured by radioimmunoassay, and the serotonin (5 HT) metabolites 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 Results The factorⅠ(anxiety) score of HAMD was 1 6±0 4, 1 5±0 4 and 2 2±0 3 in the patients with three different CSF levels of HVA (P<0 01) respectively, ranging from low to high, and there was a significant interaction between 5 HIAA and HVA (P<0 05) The factor Ⅴ(retardation) score was 2 5±0 6, 2 2±0 6, 1 7±0 5 in the patients with three different levels of SS (P<0 01) respectively, and 2 4±0 4, 2 1±0 8, 1 8±0 6 in different levers of MHPG (P<0 05), and 1 8±0 5, 2 1±0 6, 2 5±0 6 in three levers of HVA (P<0 01), and there was an interaction between SS and 5 HIAA on this factor (P<0 05) So was the factorⅥ (sleep disturbance) score (1 6±0 6, 2 0±0 0, and 1 5±0 4) in three levels of SS (P<0 01) respectively, and there was interaction between SS and HVA (P<0 01), between MHPG and HVA (P<0 05) on this symptom Conclusions It suggests that the decrease of 5 HT or NE metabolism and lower CSF SS concentration are closely related to some depressive symptoms, such as anxiety, retardation and sleep disturbance, and the alterations of DA function may involve in some symptoms such as retardation There are interactions among the various neurotransmitters, which correlate to certain depression symptoms in some degree