抑郁症患者自杀风险与下丘脑-垂体-肾上腺轴功能的研究

A Study of Suicide Risk and HPA Axis Function in Patients with Depression

目的探讨抑郁症患者不同的应激因素、汉密尔顿抑郁量表(HAMD)相关因子与下丘脑-垂体-肾上腺轴功能的相关性。方法选取106名抑郁症患者,采用创伤性生活事件量表和HAMD量表进行测评,并于治疗前测定8:00 AM血浆皮质醇浓度。结果有应激因素组和无应激因素组,治疗前8:00 AM血浆皮质醇比较差异无统计学意义(P> 0.05);无自杀想法或仅觉得生活没意思的患者,与有严重自杀行为的患者,治疗前8:00 AM血浆皮质醇比较差异有统计学意义(P <0.05);不同睡眠因子的患者HPA轴功能差异无统计学意义(P> 0.05)。结论有自杀风险的抑郁症患者,清晨血浆皮质醇水平可能升高。清晨皮质醇水平有望成为鉴别患者自杀风险的生物标记物。

Objective To investigate the correlation between different stress factors,related factors in Hamilton Depression Scale(HAMD)and hypothalamic-pituitary-adrenal axis function in patients with depression.Methods A total of 106 patients with depression were enrolled and evaluated with Traumatic Life Events questionare and the HAMD Scale,8:00 AM plasma cortisol concentrations were measured before treatment.Results There was no significant difference in plasma cortisol between stress group and non-stress group at 8:00 AM before treatment(P>0.05).There was a significant difference in plasma cortisol between the patients who had no suicidal thoughts or had no sense of life and those who had serious suicidal behaviors at 8:00 AM before treatment(P<0.05).There was no significant difference in HPA axis function among patients with different sleep factors(P>0.05).Conclusion Patients with depression at risk of suicide may have higher cortisol levels,cortisol concentration may be a biomarker to identify the risk of suicide in depressive patients.