老年患者血浆肾素-血管紧张素Ⅱ-醛固酮水平变化与抑郁的相关性研究

A correlation study between the change of plasma renin- angiotensin Ⅱ-aldosterone level and elderly depression

目的探讨老年抑郁患者的血浆肾素、血管紧张素Ⅱ、醛固酮(RAAS)含量的变化与抑郁的相关性。方法从2011年开始来我院进行治疗的确诊老年抑郁患者中抽取34例抑郁患者并应用黛力新对其治疗。分别于治疗前、后采用放射免疫法及化学发光法对其进行血浆肾素、血管紧张素Ⅱ及醛固酮含量的测定。从开始治疗到治疗结束每隔2周对患者的抑郁程度进行1次评定,评定量表选用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)。结果治疗后患者的血管紧张素Ⅱ含量为(174.01±131.19)pg/ml,明显低于治疗前的(435.82±232.80)pg/ml,两者比较差异具有统计学意义(P<0.05)。但治疗前后的血浆肾素分别为(1.64±0.89)ng/ml与(1.20±0.81)ng/ml,治疗前后的血浆醛固酮分别为(0.22±0.07)mmol/L与(0.22±0.08)mmol/L,两者治疗前后的含量变化不明显,差异无统计学意义(P>0.05)。治疗前后患者血管紧张素Ⅱ水平的变化与HAMA和HAMD的减分率间的相关系数分别的-0.429与-0.465,其相关关系为负相关,但血浆肾素与血浆醛固酮水平的变化却与HAMA和HAMD减分率间无明显的相关性。结论老年抑郁患者的血浆肾素、血管紧张素Ⅱ以及醛固酮水平之间存在着一定相关关系,且其血管紧张素Ⅱ水平变化与抑郁密切相关。

Objective To explore the correlation between the change of renin-angiotensin Ⅱ-aldosterone level and elderly depression. Methods Thirty-four patients diagnosed as elderly depression treated with deanxit in our hospital from 2011 were selected. The plasma renin-angiotensin Ⅱ-aldosterone levels of these patients were measured before and after the treatment by radioimmunoassay and chemiluminescence. The depression degrees in patients were assessed by Hamilton Anxiety Scale（HAMA） and Hamilton Depression Scale（HAMD） every two weeks from the start of the treatment to the end of the treatment. Results The angiotensin Ⅱ levels of these patients was（174.01±131.19） pg/ml after the treatment, which was significantly lower than（435.82±232.80） pg/ml before the treatment. The levels of plasma renin before and after the treatment were（1.64±0.89） ng/ml and（1.20±0.81） ng/ml respectively, and the levels of aldosterone before and after the treatment were（0.22±0.07） mmol/L and（0.22±0.08） mmol/L respectively. The changes of plasma renin and aldosterone levels before and after the treatment were of no statistically significance. The correlation index between the changes of angiotensin Ⅱ levels before and after the treatment and the reduced rate of HAMA and HAMD was-0.429 and-0.465, which was negatively correlated. However, there were no significant difference between the changes of plasma renin and aldosterone levels before and after the treatment and the reduced rate of HAMA and HAMD. Conclusion There are correlations between plasma renin, angiotensin Ⅱand aldosterone levels in elderly depression patients, and the change of angiotensin Ⅱ level is closely related to depression.