精神分裂症患者的焦虑抑郁症状与血浆皮质醇水平观察

目的观察不同病期精神分裂症患者的焦虑抑郁症状与血浆皮质醇水平的变化及两者的关系。方法以精神分裂症患者60例为研究组,于治疗前0周、治疗后2周末和4周末应用汉密顿焦虑量表（HAMA）和汉密顿抑郁量表（HAMD）分别评定患者发病期和好转期的焦虑抑郁症状,并同步测定血浆皮质醇水平,观察其焦虑抑郁程度与血浆皮质醇水平变化及分析两者的关系,同时与30名健康者作对照。结果研究组的HAMA和HAMD总分在发病期（0周和2周末）和好转期（第4周末）均显著高于正常对照组（P〈0.05或P〈0.01）;研究组的血浆皮质醇水平在发病期显著升高（P〈0.01）,随着病情的好转而恢复正常;研究组血浆皮质醇水平的变化（0周与2周末,2周末与4周末）与HAMA、HAMD总分的变化无显著相关性（P〉0.05）。结论精神分裂症患者在不同病期均可出现焦虑抑郁症状,发病期伴有血浆皮质醇水平升高,但焦虑抑郁症状与血浆皮质醇水平无明显关联。

An observation on the changes of the anxiety-depression symptoms and the level of serium cortisol in patients with schizophrenia

Objective To observate the changes of the anxiety-depression symptoms and the level of serium cortisol in patients with schizophrenia during different ill-courses. Methods Totally 60 patients with schizophrenia（the study group）were evaluated with Hamilton Anxiety Scale（HAMA）and Hamilton Depression Scale（HAMD）before treatment,after 2 weeks and after 4 weeks of treatment,and,at the same time,the levels of serium cortisol were tested,with 30 healthy controls.The changes of the anxiety-depression symptoms and the level of serium cortisol were observated and their correlation was analyzed. Results During onset period（0 week,2nd weekend of treatment）and the recovery period（4th weekend of treatment）,the scores of HAMA and HAMD in the study group were significantly higher than those of the control group（ P 〈0.05 or P 〈0.01）.The level of serium cortisol in the study group significantly increased during onset period（ P 〈0.01）and recovered with ill-condition improvement.There showed no significant correlation between the levels of serium cortisol and the changes of the total scores of HAMA and HAMD in the study group（0 week to 2nd weekend,2nd weekend to 4th weekend,P 〉0.05）. Conclusion During different ill-courses,patients with schizophrenia had some extent anxiety-depression symptoms and had higher level of serium cortisol during onset period.But there showed no significant correlation between the levels of serium cortisol and the anxiety-depression symptoms.