抑郁症患者脑白质病变与认知功能的相关性研究

目的探究脑白质病变(WML)与抑郁症严重程度及认知功能改变的相关性。方法选取98名抑郁症患者,将他们按照是否伴有脑白质病变分为观察组(WML组)37人及对照组(NWML组)61人。对全部入组患者进行Fazekas分级,完成汉密尔顿抑郁量表(HAMD-17)、蒙特利尔认知评估量表(MoCA),并收集血生化指标,比较两组患者的一般临床资料、血生化指标、抑郁症状严重程度以及认知功能改变有无差异,进一步分析脑白质病变负担与抑郁症严重程度以及认知功能改变的关系。结果Fazekas分级与HAMD总分呈正相关、与MoCA总分呈负相关(P≤0.05)。年龄≥50岁的患者中,控制年龄、高血压、受教育年限、总病程、TC、LDL-C后,Fazekas分级与HAMD总分呈正相关(r=0.548,P=0.002);控制年龄、高血压、受教育年限、总病程、TG、ApoE后,MoCA总分与睡眠障碍因子呈负相关(r=-0.399,P=0.029)。结论在抑郁症患者中,尤其是中老年患者,WML程度越重,抑郁症状越严重,认知功能损害越明显,且认知功能损害可能与睡眠障碍有关。

Correlation between white matter lesions and cognitive function in patients with depression

Objective To explore the correlation between white matter lesions(WML)and the severity and cognitive function changes of patients with depression. Methods A total of 98 patients with depression were selected and divided into observation group(WML group)37 and control group(NWML group)61,according to whether they had white matter lesions. Fazekas classification,Hamilton Depression Scale(HAMD-17),and Montreal Cognitive Assessment Scale(MoCA)were performed on all patients,and blood biochemical indicators were collected. Patients were compared for general clinical data,blood biochemical indicators,severity of depression,and cognitive function,and further analyze the relationship between the burden of white matter lesions and the severity of depressive symptoms and changes in cognitive function. Results Fazekas classification was positively correlated with HAMD total scores and negatively correlated with MoCA total scores(P≤0.05). Among patients aged ≥ 50 years,after controlling for age,hypertension,years of education,total course,TC,LDL-C,the Fazekas classification was still positively correlated with HAMD total scores(r=0.548,P=0.002);after controlling for age,hypertension,years of education,total course,TG,and ApoE,MoCA total scores were still negatively correlated with sleep disturbance factor(r=-0.399,P=0.029). Conclusion In patients with depression,especially middle-aged and elderly patients,the more severe the WML,the more severe the symptoms of depression,and the more obvious the impairment of cognitive function. Cognitive impairment may be related to sleep disorder.