血清维生素B_(12)、25(OH)D水平对老年抑郁症患者预后的影响及与病情程度的相关性

Effect of Serum Vitamin B_(12) and 25(OH)D Levels on the Prognosis of Elderly Patients with Depression and Their Correlation with the Severity of the Disease

目的观察老年抑郁症患者血清维生素B_(12)和25羟维生素D[25-hydroxy vitamin D,25(OH)D]水平,并分析二者对患者预后的影响及与病情程度的相关性。方法选取2020年3月至2022年10月就诊的110例老年抑郁症患者,全部随访1年,以随访期间病情进展为难治性抑郁症为预后评判标准,分为预后良好组和预后不良组,比较2组基线资料、就诊当日血清维生素B_(12)和25(OH)D水平,分析血清维生素B_(12)、25(OH)D水平对患者预后的影响以及不同病情程度患者血清维生素B_(12)、25(OH)D水平,并采用Pearson相关分析其与患者抑郁状态的相关性。结果随访1年后,110例老年抑郁症患者中,29例病情进展为难治性抑郁症,发生率为26.36%;预后不良组血清维生素B_(12)、25(OH)D水平均低于预后良好组(P<0.01)。多因素Logistic回归分析示,血清维生素B_(12)和25(OH)D是老年抑郁症患者预后不良危险因素(P<0.01)。中度抑郁症患者血清维生素B_(12)和25(OH)D低于轻度抑郁症患者(P<0.01)。相关性分析显示,血清维生素B_(12)和25(OH)D水平与汉密尔顿抑郁量表评分呈负相关(r=-0.425、-0.326,P<0.01)。结论血清维生素B_(12)、25(OH)D水平可对老年抑郁症患者预后产生影响,预后越差的患者维生素B_(12)和25(OH)D水平越低,二者水平检测可用于老年抑郁症患者病情的评估。

Objective To observe the levels of serum vitamin B_(12) and 25 hydroxyvitamin D[25(OH)D]in elderly pa-tients with depression,and to analyze the effects of the two on the prognosis of patients and the correlation with the severity of the disease.Methods A total of 110 elderly patients with depression treated from March 2020 to October 2022 were selected and followed up for 1 year:The patients were divided into good prognosis group and poor prognosis group according to the pro-gression to refractory depression during follow-up as a prognostic criterion.The baseline data and serum vitamin B_(12) and 25 hy-droxyvitamin D[25(OH)D]levels of the two groups were compared on the day of treatment,and the impact of serum vitamin B_(12) and 25(OH)D levels on the prognosis of patients and the serum vitamin B_(12) and 25(OH)D levels of patients with different dis-ease severity were analyzed.Pearson correlation analysis was used to explore the correlation between the levels of the above in-dicators and depression.Results At 1-year follow-up,29 patients of 110 elderly patients with depression progressed to refrac-tory depression,with an incidence rate of 26.36%.The levels of vitamin B_(12) and 25(OH)D in the poor prognosis group were lower than those in the good prognosis group(P<0.01).Multivariate Logistic regression analysis showed that serum vitamin Br2 and 25(OH)D were risk factors for poor prognosis in elderly patients with depression(P<0.01).Serum vitamin B_(12) and 25(OH)D in moderate depression patients were lower than those in mild depression patients(P<0.01).Correlation analysis showed that serum vitamin B_(12) and 25(OH)D levels were negatively correlated with Hamilton Depression Scale scores(r=-0.425,-0.326,P<0.01).Conclusion The serum levels of vitamin B_(12) and 25(OH)D can affect the prognosis of elderly patients with depression,and the poorer prognosis leads to the lower levels of vitamin B_(12) and 25(OH)D in patients.Therefore,the detection of both levels can be used to evaluate the condition of elderly patients with depression.