脑卒中后抑郁患者血清促肾上腺皮质激素研究

目的：研究脑卒中后抑郁（poststroke depression，PSD）患者血清促肾上腺皮质激素（ACTH）水平变化，探讨PSD患者的内分泌指标变化。方法：采用放射免疫法对59例PSD患者（PSD组）、36例无PSD患者（无PSD组）及43名正常人（对照组）的血清ACTH水平进行检测；并观察29例PSD患者抗抑郁治疗后血清ACTH水平变化。结果：治疗前PSD组血清ACTH水平显著高于无PSD组（P〈0．01）和对照组（P〈0．01）；治疗后，PSD抗抑郁治疗组与PSD无抗抑郁治疗组相比，汉密尔顿抑郁量表（HAMD）评分（P〈0．01）和ACTH水平（P〈0．01）均显著降低。在治疗前PSD组及在治疗后的PSD抗抑郁治疗组和PSD无抗抑郁治疗组中，HAMD评分与血清ACTH水平呈显著性正相关。结论：PSD患者血清ACTH水平明显升高并且与抑郁程度相关，提示PSD患者可能有内分泌功能的变化。

A study of the serum level of adrenocorticotrophin in patients with poststroke depression

Objective:To study the changes in the level of serum adrenocorticotrophin (ACTH) in patients with poststroke depression (PSD), and to investigate their changes in the level of endocrine indexes. Method:The serum level of ACTH was measured by radioimmunoassay in 59 patients with PSD,36 patients without PSD (NPSD) and 43 normal controls.The changes of the serum level of ACTH were observed before and after antidepressant treatment in 29 patients with PSD. Results: Compared with NPSD and normal controls,the serum level of ACTH was significantly higher in PSD before treatment (P<0.01).Compared with NPSD,both the scores of Hamilton depressive scale (HAMD) (P<0.01) and the level of ACTH (P<0.01) were lower in antidepressant treatment group after treatment.There were significantly positive correlation in the level of ACTH and the scores of HAMD in PSD group before treatment,also in PSD group with or without antidepressant treatment after treatment. Conclusion: The serum level of ACTH in PSD increase significantly,which is related to the severity of depression.It is possible for PSD to have endocrine functional changes.