伴抑郁的功能性消化不良机制初探

Mechanism of functional dyspepsia accompanied by mild-to-moderate depression

目的:探索伴轻中度抑郁的功能性消化不良(functional dyspepsia,FD)患者血浆和胃黏膜中5-羟色胺(5-hydroxytryptamine,5-HT)与不伴抑郁的FD患者间的差异,为实验室评估FD患者抑郁程度和治疗疗效提供理论依据。方法:门诊FD患者经医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)抑郁评分分为2组,即伴轻中度抑郁的FD试验组30例和不伴抑郁的FD对照组30例,采集2组患者的血液和胃黏膜标本,酶联免疫吸附法(enzyme-linked immunosorbent method,ELISA)法检测血浆及胃黏膜中5-HT的含量。结果:试验组血浆及胃黏膜5-HT含量均较对照组增高,2组差异有统计学意义(P=0.000);抑郁程度评分与血浆5-HT含量成正相关(r=0.921,P=0.000),同时也与胃黏膜5-HT含量成正相关(r=0.954,P=0.000)。结论:FD伴轻中度抑郁时存在神经内分泌的异常,5-HT在其发病过程中起重要作用,其可作为FD患者抑郁程度评估和抗抑郁疗效评估的依据之一。

Objective：To explore the difference of 5-hydroxytryptamine（5-HT）between functional dyspepsia（FD）patients with or without mild-to-moderate depression and to provide theoretical basis for the treatment and assessment. Methods：Clinic patients with FD were divided into two groups based on hospital anxiety and depression scale（HADS）：trial group（30 FD patients with mild-tomoderate depression）and control group of（30 FD patients without depression）. The blood specimen and gastric mucosa specimen from the two groups were collected. ELISA was applied to detect 5-HT content in plasma and gastric mucosa. Results：The 5-HT content of plasma and gastric mucosa was higher in trial group than in control group,with statistically significant differences between the two groups（P=0.000）. Depression score was related with the 5-HT content of plasma（r=0.921,P=0.000）and gastric mucosa（r=0.954,P=0.000）. Conclusion：FD complicated with mild-to-moderate depression will incure abnormal change of neuroendocrine. 5-HT may play an important role in the course of illness and can be used as criterion to assess depression severity and antidepressant efficacy for FD patients.