摘要
目的 探讨C 反应蛋白 (C reactiveprotein ,CRP)在恶劣心境发病中的作用及其对治疗的影响。方法 选择本院确诊为恶劣心境的患者 ,用氟西汀进行治疗 ,有睡眠障碍者加用阿普唑仑。应用TurboxR特定蛋白分析系统 (芬兰 )以散射比浊法测定治疗前空腹血清CRP含量 ;并采用 17项版本的Hamilton抑郁量表 ,分别于治疗前及治疗后 1个月、2个月进行评定。选取同期正常健康人 5 0例作为对照。结果 正常对照组所有患者HAMD评分均在 17分以下 ,其血清CRP含量处于较低水平。恶劣心境组CRP异常率为 43 8% (4 2 96)。恶劣心境患者其平均血清CRP含量与正常对照组相比显著增高 (P <0 0 1) ,其中CRP正常组CRP含量的平均水平与正常对照组相比 ,差异无显著意义 (P >0 0 5 ) ,而CRP增高组与正常对照组相比 ,其差异具有极显著意义 (P <0 0 0 1)。治疗前 ,CRP正常组与CRP增高组HAMD评分无显著差异 ;治疗后 1个月 ,CRP正常组HAMD评分的降低明显高于CRP增高组 (P <0 0 5 ) ;治疗后 2个月 ,两组患者HAMD评分无显著差异 (P >0 0 5 )。结论 血清CRP可能是恶劣心境的重要诱发因子 ,它不影响抑郁发作的严重程度 ,但可影响恶劣心境的早期疗效。
Objective To investigate the roles of c-reactive protein (CRP) in the onset of dysthymia and its effects on the therapeutic efficacy. Methods Ninety six patients with dysthymia (male:37, female: 59) were examined using Hamilton depression scale (HAMD) to determine their status of depression at 2 months before and after treatment with fluoxetine. Another 50 normal subjects were employed as the controls. CRP levels were measured by scatter turbidimetry by TurboxR special protein analysis system (Finland) in all subjects. Results All depression scores of normal subjects according to HAMD depression scale were under 17 and their serum CRP concentrations were at a basic level. The prevalence rate of increase of serum c-reactive protein in dysthymia was 43.8%(42/96). The average serum CRP level in patients with dysthymia was significantly higher than that in normal subjects (P<0.001). The patients with normal serum c-reactive protein had the same level of serum CRP as that in the normal controls. Those patients with high level of serum c-reactive protein had significantly higher level of serum CRP than that of the normal controls (P<0.01). Before treatment with fluoxetine, the HAMD score of patients with normal serum CRP level was similar to that of patients with high serum CRP level. At 1 month after treatment with fluoxetine, the HAMD score with normal serum CRP level decreased significantly than that of patients with high serum CRP level. There was no significant difference in HAMD scores in the two groups at 2 months after treatment (P>0.05). Conclusion Serum CRP concentration maybe an important evoking factor of dysthymia. It may not increase the severity of depression but may impede the early improvement of symptoms.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2004年第23期2152-2154,共3页
Journal of Third Military Medical University
