抑郁症患者血管内皮功能的异常改变

Abnormal change of vascular endothelial function in patients with major depressive disorder

目的:探讨抑郁症患者血管内皮功能的改变。方法:运用日立-图腾彩色多普勒超声诊断仪高频探头检测24例抑郁症患者(抑郁症组)和20名健康对照者(健康对照组)肱动脉反应性充血前后血管内径的变化(即血流介导的内皮依赖性血管扩张,FMD)及舌下含服硝酸甘油后的内径变化(即非内皮依赖性舒张功能,NMD);同时测定两组血浆一氧化氮水平(NO);采用汉密尔顿抑郁量表(HAMD)和Beck抑郁量表(BDI)评定抑郁症组患者抑郁的严重程度。结果:与健康对照组相比,抑郁症组FMD较健康对照组明显降低(t=3.62,P<0.01);两组NMD比较差异无统计学意义(t=1.55,P>0.05)。抑郁症组的血浆NO水平明显低于健康对照组(t=3.63,P<0.01)。相关分析显示,抑郁症组HAMD及BDI得分与FMD负相关(r=-0.687,r=-0.621;P均<0.05);两组血浆NO水平与FMD正相关(r=0.726,r=0.743;P均<0.05)。结论:抑郁症患者血管内皮功能受损可能与血浆NO水平减低及抑郁严重程度有关。

Objective：To investigate the change of vascular endothelial function in patients with major depressive disorder using high frequency ultrasound. Method ： Flow-mediated dilation （ FMD ） and nitroglycerin-mediated dilation （NMD）were measured in 24 patients with major depressive disorder and 20 age and gender matched-healthy controls by high frequency ultrasound （hitachi vision ascendus）. In addition, the plasma ni- trogen dioxide （ NO ） levels and severity of depression, as assessed by the Hamilton depression rating scale （HAMD） and Beck depression inventory （ BDI ） score, were also determined. Results： The increased percentage of FMD in patients with major depressive disorder were significantly lower than that in healthy controls（ t = 3.62 ,P 〈 0.01 ）. However, the increased percentage of NMD showed no markedly difference between the two groups （ t = 1. 55, P 〉 0. 05 ）. In addition, the levels of plasma NO were decreased in patients with major depres- sive disorder as compared with healthy controls（ t = 3.63 ,P 〈 0.01 ）. Further correlation analyses indicated both the HAMD and BDI scores （ r = - 0. 687, r = - 0.621, all P 〈 0.05 ） were negatively associated with the altered percentage of FMD in patients with major depressive disorder. But, plasma NO levels were positively associated with the altered percentage of FMD in patients with major depressive disorder and healthy controls （ r = 0. 726, r = 0.743, all P 〈 0.05 ）. Conclusion ： The impaired vascular endothelial function may be associated with the decreased plasma. NO levels and the severity of depression in patients with major depressive disorder, and high frequency ultrasound can serve as a safe and noninvasive method to assess the impairment of vascular endotheli- al function in these patients.