度洛西汀对抑郁障碍患者骨代谢影响的对照研究

目的采用骨转化标志物的血浓度比较，评估抗抑郁药物度洛西汀对抑郁障碍患者骨代谢的影响。 方法使用病例-正常对照、治疗前后对照的方法，于2020年9月至2022年2月，在无锡市中医医院临床心理科和无锡市精神卫生中心临床心理科招募抑郁障碍患者（患者组）49例和性别年龄相匹配的健康对照组（对照组）49例，以及患者组使用度洛西汀治疗前后比较。采用电化学发光免疫分析法，检测血液骨转化标志物1型胶原c-端交联末端肽（β-CTX）和1型前胶原n-前肽（P1NP）浓度。 结果在基线时，2组β-CTX（pg/ml）存在统计学差异，患者组显著高于正常组［321.1（189.4）vs 210.4（103.5），t=-3.59，P=0.001］，而P1NP（ng/ml）没有统计学差异（P＞0.05）。患者组经治疗，β-CTX从321.1（189.4）显著性升高为475.3（192.4）（P=0.001），P1NP从49.9（19.8）虽然升高为54.5（27.6），但差异没有统计学意义（P＞0.05）。 结论抑郁障碍患者比对照组骨吸收增加，经度洛西汀治疗后骨吸收更明显，可能会增加骨折风险。

Comparative study of effect of duloxetine on bone metabolism in patients with depressive disorder

ObjectiveTo evaluate the effect of the antidepressant duloxetine on bone metabolism in patients with depression by comparing the blood concentration of bone turnover markers. MethodsFrom September 2020 to February 2022, 49 patients with depressive disorder (patient group) and 49 sex- and age-matched healthy controls (normal group) were recruited at the Department of Clinical Psychology of Wuxi Hospital of Traditional Chinese Medicine and the Department of Clinical Psychology of Wuxi Mental Health Center. Blood concentrations of bone transformation markers including C-terminal cross-linking telopeptide of type I collagen (β-CTX) and N-terminal propeptide of type I procollagen (P1NP) were detected by electrochemiluminescence immunoassay. Comparisons were performed between the patient group and the normal group, and between patients before and after treatment with duloxetine. ResultsAt baseline, β-CTX (pg/ml) was significantly higher in the patient group than in the normal group 321.1 (189.4) vs 210.4 (103.5), t=-3.59, P=0.001], but there was no significant difference in P1NP (P＞0.05). After treatment, β-CTX increased significantly from 321.1 (189.4) to 475.3 (192.4) in the patient group (P=0.001); P1NP increased from 49.9(19.8) to 54.5(27.6), but there was no significant difference. ConclusionBone resorption in patients with depression is higher than that in healthy people, and it is more obvious after treatment with duloxetine, which may increase the risk of fracture.