5-羟色胺和胆固醇水平对抑郁症患者再次自杀风险评估的研究

目的 探讨抑郁症患者血小板5-羟色胺（5-HT）和胆固醇水平与抑郁症患者再次自杀的关系.方法 对33例有自杀行为的抑郁症患者在接受治疗前测定血小板5-HT和胆固醇水平,评定汉密尔顿抑郁量表（HAMD-24）和Beck绝望量表（BHS）,然后进行2年的随访.结果 16例患者再次出现自杀行为,再次自杀组血小板5-HT及血清胆固醇水平显著低于无再次自杀组（P＜0.01）.5-HT和血清胆固醇水平与HAMD-24、BHS分及自杀次数、自杀严重程度均呈负相关（P＜0.01）,且5-HT与血清胆固醇水平呈正相关（P＜0.01）.多重回归分析显示血小板5-HT浓度、家族史是自杀次数的主要影响因素.结论 低血小板5-HT及血清胆固醇浓度是抑郁症自杀的危险因素,对抑郁症自杀行为可能具有一定的的预测作用.

Predictive effect of level of platelet serotonin and serum cholesterol on the risk of re-suicide behaviors in patients with depression

Objective To explore the relationship between platelet serotonin, serum cholesterol and re-suicide behaviors in patients with depression. Methods Levels of platelet serotonin and serum cholesterol were measured in 33 depressive patients with suicidal behavior before the antidepressant treatment. All patients were assessed with Hamilton Depression Rating Scale-24 items （HAMD-24） and Beck Helpless Rating Scale （BHS）, then were followed up for 2 years. Results The re-suicice behavior were recorded in 16 patients. Levels of platelet serotonin and serum cholesterol were significantly lower in patients with re-suicide behavior than those without re-suicide behavior （ P 〈 O. 01 ）. Levels of platelet serotonin and serum cholesterol were negatively correlated with score of HAMD-24, score of BHS, frequency of suicide, severity of suicidal behavior （ P 〈 O. 01 ）. Level of platelet serotonin was positively correlated with level of serum cholesterol （ P 〈 0.01 ）. Multiple regression analysis showed that level of platelet serotonin and positive family history were the main influencing factors of the frequency of suieidal behavior. Conclusion Low level of platelet serotonin and serum cholesterol are the risk factors of suicidal behaviors in depressive patients. They are likely to have predictive effect on suicidal behaviors.