抑郁症自杀未遂者血浆瘦素及总胆固醇水平研究

目的 探讨血浆瘦素及总胆固醇与抑郁发作自杀未遂的关系.方法 对抑郁发作自杀未遂者(自杀未遂组,25例)和抑郁发作无自杀行为者(无自杀组,30例)采用汉密尔顿抑郁量表(HAMD24)、Beck绝望量表(BHS)及自杀意念自评量表(SIOSS)评定抑郁严重程度、绝望程度和自杀意念的强烈程度;32例体检职工为对照组,所有入组对象服药前测定体质量指数、血浆瘦素和总胆固醇.结果 (1)自杀未遂组的HAMD-24[(38.9±9.4)分]、BHS[(13.4±4.1)分]、SIOSS评分[(17.8±4.1)分]均高于无自杀组[分别为(26.2±6.3)分、(7.8±4.0)分、(12.5±4.3)分;P＜0.01].(2)自杀未遂组的总胆固醇[(3.3±0.9)mmol/L]及血浆瘦素水平[(6.1±3.7)μg/L]明显低于无自杀组[分别为(3.6±1.2)mmol/L,(9.4±4.4)g/L;P＜0.05～0.01],而无自杀组又明显低于正常对照组[分别为(4.8±0.9)mmol/L,(13.4±6.7)μg/L;P＜0.05～0.01].(3)3组的血浆瘦素及总胆固醇均与BMI呈正相关(P＜0.01);自杀未遂组和无自杀组血浆瘦素和总胆固醇与HAMD-24分、BHS及SIOSS分均呈显著负相关,且两组的血浆瘦素与总胆固醇之间呈显著正相关(P＜0.01);而正常对照组的血浆瘦素与总胆固醇之间无显著相关性(P＞0.05).结论 低水平的血浆瘦素可能是抑郁发作自杀未遂的一个危险因素.

A study on plasma leptin and total cholesterol in attempted suicide depressive patients

Objective To investigate the possible role of plasma leptin and total cholesterol in the pathophysiology of attempted suicide in depressive episode patients. Methods The subjects were 25 depressive episode patients who had recently attempted suicide and 30 depressive episode patients without suicide attempt. The Hamilton Depression Rating Scale-24 items ( HAMD24 ), Beck Helpless Rating Scale (BHS) and Self-rating Idea of Suicide Scale (SIOSS) were used to evaluate the severity of symptoms. In addition, 32 individuals who took part in health examination were selected as health control group. Body height and weight were measured to get body mass index (BMI) of all objects, and plasma leptin and total cholesterol were measured by venous blood before taking pill. Results (1)HAMD score , BHS score and SIOSS score in patients with attempted suicide were higher than patients without suicide (P ＜ 0.01 ). (2) The total cholesterol and plasma leptin in patients with attempted suicide ( (3.3 ±0.9)mmol/L, (6.1 ±3.7)μg/L)were lower than that in patients without suicide( (3.6± 1.2)mmol/L, (9.4 ± 4.4)μg/L; P ＜ 0.05 ～ 0. 0l ), while total cholesterol and leptin in patients without suicide attempt ( (3.6 ± 1.2 ) mmol/L, ( 9.4 ± 4.4 ) μg/L) were lower than that in normal controls ( ( 4.8 ± 0.9 )mmol/L, ( 13.4 ± 6.7 ) μg/L; P ＜ 0.05 ～ 0.01 ). (3) Plasma leptin and total cholesterol of all patients were positively correlated with BMI(P＜0.01 ). Moreover, plasma leptin and total cholesterol in patients with attempted suicide and patients without attempted suicide were inversely positively correlated with HAMD score , BHS score and SIOSS score. Plasma leptin was significantly positively correlated with total cholesterol in patients with attempted suicide and patients without suicide, but there was no significant difference in normal controls(P＞ 0. 05). Conclusion The results suggest that decreased plasma leptin is related to the pathophysiology of attempted suicide in depressive episode patients.