难治性抑郁症患者血清胰岛素和神经内分泌激素的对照研究

目的研究难治性抑郁症患者治疗前后血清胰岛素和神经内分泌激素变化。方法难治性抑郁症患者(TRD组)、非难治性抑郁症患者(NTRD组)、健康者(正常对照组)各60例为研究对象,使用HAMD量表评估患者的临床症状,检测患者血清胰岛素、皮质醇(CORT)、促肾上腺皮质激素(ACTH)、三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、甲状腺素(T4)、游离甲状腺素(FT4)、促甲状腺激素刺激激素(TSH)等神经内分泌激素水平,并进行治疗前后各组上述指标的统计学处理。结果 TRD组血清胰岛素、CORT、ACTH、T3、FT3、T4、FT4、TSH与正常对照组存在显著差异,血清胰岛素、CORT、ACTH、FT4与NTRD组存在显著差异;NTRD组血清CORT、ACTH、T3、FT3、T4、FT4、TSH等与正常对照组存在显著差异(P0.05);治疗后,TRD组胰岛素、CORT、ACTH、FT3、FT4、TSH与对照组存在显著差异,而NTRD组CORT与对照组存在显著差异(P0.05)。结论 TRD患者HPA轴功能亢进、HPT轴功能低下等较NTRD患者更为严重,药物治疗后仍存在显著差异。

The clinical study of serum insulin and neuroendocrine hormones in patients with treatment-resistant depression

Objective To investigagte the changes of serum insulin and neurt~ndocrine hormones in patients with treatment - resistant depression before and after treatment. Methods Sixty patients with treatment - resistant depression （ TRD group） and sixty patients with non- treatment -resistant depression （NTRD group）were enrolled, and another sixty healthy individuals were served as normal controls （control group ）. The clinical symptoms in patients were evaluated with Hamilton depression scale （HAMD） , and serum insulin, CORT, ACTH, T3,171＂3, T4, FT4 and TSH were also tested. Then the data from each group were statis- tically analyzed before and after treatment. Results There were significant differences between TRD group and control group in se- rum insulin,CORT,ACTH,T3 ,FT3 ,T4 ,FT4 and TSH,while serum insulin. CORT,ACTH and FT4 were significantly different from those in NTRD group. Serum,CORT,ACTH,T3 ,T3 ,T4 ,FT4 and TSH in NTRD group were significantly different from those in control group（ P 〈 0. 05 ）. After treatment, there were significant differences between TRD group and control group in insulin, CORT,ACTH,F4 and TSH,while CORT in NTRD group were significantly different from that in control group（P 〈0. 05）. Conclusion Comparted to the NTRD group, HPA axis hyperthyroidism and HPT axis hypofunction in patients are more serious in TRD group, and they are still obviously anomalous after pharmacotherapy.