乳腺癌合并抑郁病人血清神经递质浓度变化及其与病情严重程度关系研究

目的探讨乳腺癌合并抑郁病人血清神经递质浓度变化及其与病情严重程度关系。方法选取行乳腺癌根治性术后辅助化疗且合并抑郁的病人60例作为观察组，病人抑郁自评量表（SDS）评分≥53分；择同期行乳腺癌根治性术后辅助化疗无抑郁的病人60例作为对照组，SDS评分 < 53分。根据SDS评分将观察组病人分为重度抑郁组18例（SDS≥72分）、中度抑郁组20例（SDS为63~72分）及轻度抑郁组22例（SDS为53~62分）。检测病人外周血中5-羟色胺（5-HT）、神经肽Y（NPY）、多巴胺（DA）和去甲肾上腺素（NE）水平并观察其与抑郁严重程度的关系。结果观察组血清5-HT、DA、NPY、NE水平较对照组显著降低（P < 0.01）。重度抑郁组血清5-HT、DA、NPY、NE水平低于中度抑郁组及轻度抑郁组，中度抑郁组血清5-HT、DA、NPY、NE水平低于轻度抑郁组，差异均有统计学意义（P < 0.01）。观察组抑郁治疗后5-HT、DA、NPY、NE水平较治疗前均显著增高（P < 0.01）。乳腺癌术后化疗伴抑郁病人血清5-HT、DA、NPY、NE水平与SDS评分均呈负相关（r=-0.575、-0.601、-0.568、-0.612，P < 0.01）。结论乳腺癌合并抑郁病人血清神经递质浓度下降，神经递质浓度与抑郁严重程度呈负相关。

Study on the relationship between serum neurotransmitter concentration and severity of disease in patients with breast cancer complicated with depression

ObjectiveTo investigate the relationship between serum neurotransmitter concentration and severity of disease in patients with breast cancer complicated with depression.MethodsSixty breast cancer complicated with depression patients(SDS score ≥ 53 points) and 60 breast cancer complicated without depression patients(SDS score < 53 points) treated with adjuvant chemotherapy after radical mastectomy were divided into the observation group and control group, respectively.According to SDS score, the observation group was subdivided into the severe depression group(18 cases, SDS score ≥ 72 points), moderate depression group(20 cases, SDS score of 63 to 72 points) and mild depression group(22 cases, SDS score of 53 to 62 points).The levels of 5-hydroxytryptophan(5-HT), neuropeptide Y(NPY), dopamine(DA) and norepinephrine(NE) in peripheral blood in two groups were measured, and their relationship with the severity of depression in the observation group was observed.ResultsThe serum levels of 5-HT, DA, NPY and NE in observation group were significantly lower than those in control group(P < 0.01).The serum levels of 5-HT, DA, NPY and NE in severe depression group were lower than those in moderate depression group and mild depression group(P < 0.01), and the serum levels of 5-HT, DA, NPY and NE in moderate depression group were lower than those in mild depression group(P < 0.01).The serum levels of 5-HT, DA, NPY and NE in the observation group after anti-depression treatment significantly increased compared with before treatment(P < 0.01).The serum levels of 5-HT, DA, NPY and NE in breast cancer complicated with depression patients treated with chemotherapy after operation were negatively correlated with the SDS score(r=-0.575, -0.601, -0.568, -0.612, P < 0.01).ConclusionsThe serum neurotransmitter concentration decreases in breast cancer complicated with depression patients, and the neurotransmitter concentration is negatily correlated with the severity of depression.