老年抑郁症持续认知功能损害的随访研究

发布时间：2019-06-05 04:47

【摘要】：目的探讨首发老年抑郁症患者抑郁症状与认知功能损害之间的关系，并进一步分析其认知功能损害的特点。 方法共入选首发老年抑郁症伴有认知功能损害患者30例(A组）和不伴认知功能损害患者34例（B组），，无抑郁的轻度认知功能损害者31例（C组），正常老年人31例（D组），均随访12个月后进行比较分析。在基线、12个月时进行老年抑郁量表(The Geriatric DepressionScale,GDS)、简易智能状态检查（Mini-Mental State Examination,MMSE）、数字广度、连线测验A、B（Trail making test,TMT-A、TMT-B)评定，并检测基线时apoE基因型。对老年抑郁症患者用选择性五羟色胺回吸收抑制剂(selective serotonin reuptake inhibitor, SSRI)进行治疗。采用SPSS17.0统计软件，运用t检验、卡方检验、方差分析、相关分析等对资料进行分析。P＜0.05为有统计学意义。 结果 1. A、B两组患者经SSRI抗抑郁治疗，12个月时A组GDS评分高于B组（P 0.01）；A组MMSE升高，但低于B组（P 0.01），高于C组（P 0.01）。B组12个月时MMSE评分无明显变化（P0.05），GDS评分有显著下降（P 0.01）。 2. A组12个月时MMSE评分与GDS评分存在负相关，而B组MMSE评分与年龄负相关。 3.四组间ApoEε4基因的表达无统计学差异（P0.05）。A组12个月时MMSE与携带ApoEε4基因相关。C组MMSE与携带ApoEε4基因相关。B组和D组12个月时MMSE与年龄呈负相关，与ApoEε4基因不相关。 4.12个月时A组顺背、倒背、总数均高于基线时，差异有统计学意义（P0.01）；B组倒背、总数均高于基线时，差异有统计学意义（P0.01）；C组总数高于基线时（P0.05）。基线时、12个月时A组顺背、倒背、总数均低于B组和D组，差异有统计学意义（P0.01）。基线时A组顺背、倒背、总数与C组相仿（P0.05）;但12个月时均高于C组（P0.01）。 5.12个月时A组和B组TMT-A、TMT-B时间均高于基线时，差异有统计学意义（P0.01）。A组TMT-A测验时间与B组相仿（P0.05）；而TMT-B测验时间高于B组（P0.01）。A、B两组TMT-A、TMT-B时间均低于C组（P0.01）。 结论 1.伴认知功能损害的老年抑郁症患者对抗抑郁治疗反应比不伴认知功能损害患者差；抗抑郁治疗对老年抑郁症伴发的认知功能损害有改善作用。 2.抑郁可能是认知功能损害的危险因素，两者共病时影响各自的转归。 3. ApoEε4基因是认知功能损害的危险因素。老年抑郁症患者认知功能持续损害与携带ApoEε4基因相关。 4.老年抑郁症患者的认知功能损害与MCI有区别，数字广度和TMT-A、TMT-B在辨别两者认知功能损害上有一定的辅助识别作用。
[Abstract]:Objective to investigate the relationship between depressive symptoms and cognitive impairment in first-episode elderly patients with depression, and to further analyze the characteristics of cognitive impairment. Methods A total of 30 patients with first-episode elderly depression with cognitive impairment (group A), 34 patients without cognitive impairment (group B) and 31 patients with mild cognitive impairment without depression (group C) were enrolled in this study. 31 cases of normal elderly (group D) were followed up for 12 months. The geriatric depression scale (The Geriatric DepressionScale,GDS), simple mental state test (Mini-Mental State Examination,MMSE), digital breadth, connectivity test A, B (Trail making test,TMT-A,TMT-B) were performed at baseline, 12 months. The apoE genotype was detected at baseline. Elderly patients with depression were treated with selective serotonin reabsorption inhibitor (selective serotonin reuptake inhibitor, SSRI). The data were analyzed by SPSS17.0 statistical software, t test, chi square test, variance analysis and correlation analysis. Result 1. A, the GDS score of group A was higher than that of group B at 12 months after antidepressant treatment with SSRI in group B (P < 0.01), and the score of GDS in group A was higher than that in group B (P < 0.01). The MMSE of group A was higher than that of group B (P 0.01), and that of group C was higher than that of group C (P < 0.01). There was no significant change in MMSE score in group A at 12 months (P < 0.05). The), GDS score of group A was significantly lower than that of group B (P < 0.01). two銆

本文编号：2493264