摘要
目的探讨急性期老年单相与双相抑郁障碍患者探索性眼球运动(exploratory eye movement,EEM)及下丘脑-垂体-肾上腺轴(hypothalamic-pituitary-adrenal axis,HPA)指标的不同特点。方法收集双相抑郁障碍老年患者38例(双相组)、重性抑郁障碍老年患者39例(单相组),使用24项版汉密尔顿抑郁量表(Hamiltom depression rating scale,HAMD-24)评估抑郁症状,检测外周血清促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、皮质醇(cortisol,COR)水平,并进行EEM检测以获得眼球运动凝视点数(number of eye fixation,NEF)、反应性探索分(responsive search score,RSS)、判别分析(discriminant analysis,D)值。结果与单相组比较,双相组患者首发年龄早、病程长、入院次数多(均P<0.05),HAMD-24评分组间无统计学差异(P>0.05);单相组ACTH、COR水平高于双相组(P<0.05),且ACTH、COR水平异常比例较双相组高(P<0.05);单相组EEM检测中D值高于双相组,RSS值低于双相组(P<0.05),两组NEF差异无统计学意义(P>0.05)。单相组D值与COR水平呈正相关(r=0.482,P=0.002),与其他指标无统计学相关性(P>0.05);而双相组未发现EEM各指标与其他指标有统计学相关性(均P>0.05)。结论急性期老年单双相抑郁障碍患者临床表现、血清ACTH和COR水平、EEM指标存在不同特点,提示两种疾病可能存在异质性。
Objective To explore the characteristics of exploratory eye movement(EEM)and hypothalamic-pituitary-adrenal axis(HPA)in elderly patients with acute bipolar and unipolar depression.Methods Thirty-eight elderly patients with bipolar depression(bipolar group)and thirty-nine patients with unipolar depression(unipolar group)were enrolled.The 24-item Hamilton depression rating scale(HAMD-24)was used to evaluate depressive symptoms.The levels of peripheral serum adrenocorticotropic hormone(ACTH)and cortisol(COR)were detected.EEM was recorded to obtain the number of eye fixation(NEF),responsive search score(RSS)and discriminant analysis(D).Results Compared with the unipolar group,the bipolar group had earlier onset,longer duration,and more admissions(P<0.05).In comparison with the bipolar group,the unipolar group had higher levels of ACTH and COR(P<0.05),and higher abnormal proportion of COR and ACTH levels.D-values were higher and RSS-values were lower in unipolar group than in bipolar group.There were no significant differences in NEF and HAMD total scores and its subfactors between the two groups(P>0.05).Correlation analysis showed that the D value of unipolar group was positively correlated with COR level(r=0.482,P=0.002)but not with other indexes(P>0.05).There were no significant correlations between EEM parameters and serum levels of HPA hormones in bipolar group(P>0.05).Conclusion There are different clinical features,EEM indicators,the serum levels of ACTH and COR between acute unipolar and bipolar depression,which suggests the heterogeneity between the two diseases.
作者
甄文凤
马辛
王红星
ZHEN Wenfeng;MA Xin;WANG Hongxing(The National clinical research Center for Medical Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University&the Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing,100088,China;不详)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2019年第11期647-651,共5页
Chinese Journal of Nervous and Mental Diseases
