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双相障碍抑郁发作患者治疗前后E2、PRL、CRP水平变化及对疗效的预测价值
Changes in E2, PRL, CRP levels and efficacy before and after treatment with bipolar depressive episode
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DOI | |
刊名 |
Journal of International Psychiatry
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年,卷(期) | 2022, 49(3) |
作者 |
王永良*,
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作者单位 |
洛阳市第五人民医院精神十九科 ; |
摘要 |
【摘要】 目的:探究双相障碍(BD)抑郁发作患者治疗前后雌二醇(E2)、催乳素(PRL)、C反应蛋白(CRP)水平变化及与疗效的关系。方法:回顾性分析2019年9月至2021年9月本院收治BD抑郁发作患者116例为BD组,均给予常规抗抑郁治疗;另以BD患者性别、年龄进行配伍,选取同期健康体检者58例为对照组,采用汉密尔顿抑郁量表17项版(HAMD-17)评估患者的疗效,并检测两组E2、PRL、CRP水平。以Logistic回归分析E2、PRL、CRP水平与疗效的关系,以ROC曲线评估E2、PRL、CRP水平对疗效的预测价值。结果:组内比较,与治疗前相比,治疗后BD组患者E2水平显著升高(P<0.05),CRP水平显著降低(P<0.05);组间比较,BD组患者治疗前E2水平显著低于对照组,CRP水平显著高于对照组(P<0.05)。经治疗后,BD抑郁发作患者治疗总有效率为81.90%(95/116),治疗无效率为18.10%(21/116)。单因素结果显示,BD抑郁发作患者的性别、年龄、PRL水平与疗效无关(P>0.05);而病程、发作次数、抑郁程度、E2、CRP水平与疗效有关(P<0.05)。多因素Logistic回归分析显示,病程≥6个月、发作次数≥5次、CRP水平降低均为为BD抑郁发作患者疗效的危险因素(P<0.05),E2水平升高、抑郁程度为轻中度为BD抑郁发作患者疗效的保护因素(P<0.05)。ROC结果显示,E2、CRP水平预测疗效的AUC分别为0.795、0.986,均具有一定准确性。结论 血清E2水平降低、CRP水平升高与BD抑郁发作密切相关,且二者可作为BD抑郁发作疗效的预测指标。
【Abstract】 Objective: To explore the relationship between estradiol (E2), prolactin (PRL) and C-reactive protein (CRP) levels before and after treatment in patients with bipolar disorder (BD) depressive episodes and their relationship with curative effect.Methods:A retrospective analysis of 116 patients with BD depressive episode admitted to our hospital from September 2019 to September 2021 were included in the BD group, and they were all given conventional antidepressant treatment. In addition, the gender and age of BD patients were compatible with each other, and 58 healthy physical examination patients were selected during the same period. In the control group, the 17-item Hamilton Depression Scale (HAMD-17) was used to evaluate the curative effect of patients, and to detect the levels of E2, PRL, and CRP in the two groups. Logistic regression was used to analyze the relationship between E2, PRL, CRP levels and curative effect, and ROC curve was used to evaluate the predictive value of E2, PRL, CRP levels on curative effect. Results: TheComparison within the group, compared with before treatment, the E2 level of patients in the BD group was significantly increased after treatment (P<0.05), and the CRP level was significantly reduced (P<0.05); compared between the groups, the E2 level of patients in the BD group was significantly lower than before treatment In the control group, the CRP level was significantly higher than that in the control group (P<0.05). After treatment, the total effective rate of treatment for patients with BD depressive episode was 81.90% (95/116), and the treatment response rate was 18.10% (21/116). The univariate results showed that the gender, age, and PRL level of patients with depressive episodes of BD were not related to the efficacy (P>0.05); while the duration of the disease, the number of episodes, the degree of depression, E2 and CRP levels were related to the efficacy (P<0.05). Multivariate logistic regression analysis showed that the course of disease ≥6 months, the number of episodes ≥5, and the decrease in CRP level were all risk factors for the efficacy of BD depressive episodes (P<0.05), and the E2 level increased and the degree of depression was mild to moderate. It is a protective factor for the curative effect of patients with BD depressive episode (P<0.05). ROC results show that the AUC of E2 and CRP levels for predicting curative effect are 0.795 and 0.986, respectively, and both have certain accuracy. Conclusion: The decrease of serum E2 level and the increase of CRP level are closely related to BD depressive episodes, and the two can be used as predictors of the efficacy of BD depressive episodes.
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关键词 |
【关键词】双相情感障碍;抑郁发作;雌二醇;催乳素;C反应蛋白;疗效
【Key words】Bipolar disorder; Depressive episode; Estradiol; Prolactin; C-reactive protein; Efficacy
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基金项目 | |
页码 | 458-461 |