目的 探讨血管性抑郁患者脑白质改变及其对药物的反应性,为临床诊治提供指导。方法 选取2017-04至2018-12北京市隆福医院就诊年龄大于65岁的血管性抑郁患者,采用抑郁自评量表进行抑郁评估(SDS),采用蒙特利尔认知评价量表进行认知评估(MoCA),并进行头部MRI检查。对受试者抑郁量表评分SDS与MRI白质高信号评分、MoCA评分进行相关性分析,并给予艾司西酞普兰治疗12周后,复查SDS,观察治疗效果。结果 (1)SDS分别与MRI侧脑室白质评分、深部白质评分、Fazekas评分均具有明显正相关性,相关系数r分别为0.719、0.651、0.700,P值均为0.000。SDS与MoCA有明显负相关性,相关系数r为-0.696,P=0.000。(2)艾司西酞普兰治疗后SDS评分降低,治疗前后有统计学差异(t=12.899,P=0.000)。结论 头部MRI白质高信号与血管性抑郁明显相关,是抑郁的危险因子;艾司西酞普兰对血管性抑郁治疗效果较好。
Abstract
Objective To investigate changes of white matter in patients with vascular depression and its response to drugs, and to provide data for clinical diagnosis and treatment.Methods Depression patients over 65 who were treated at Beijing Longfu Hospital between April 2017 and December 2018 were selected and assessed with the self-rating depression scale (SDS) and Montreal Cognitive Assessment (MoCA). Head MRI was performed. The correlations between SDS scores of the depression scale, MRI high signal scores of white matter and MoCA scores were analyzed. After 12 weeks of treatment with escitalopram , SDS was calculated a second time and the therapeutic effect was observed.Results (1) SDS had a significant positive correlation with MRI lateral ventricle white matter scores, deep white matter scores, and Fazekas scores, respectively. The correlation coefficient r was 0.719, 0.651, and 0.700, respectively, and P values were all 0.000. SDS had a significant negative correlation with MoCA, and the correlation coefficient r was -0.696 and P=0.000. (2) After treatment with escitalopram, SDS scores decreased, and there was statistically significant difference after treatment(t=12.899,P=0.000).Conclusions The white matter high signals displayed by the head MRI are associated with vascular depression and is a risk factor for depression. Escitalopram has a good effect on vascular depression.
关键词
血管性抑郁 /
脑白质高信号 /
艾司西酞普兰
Key words
vascular depression /
white matter high signals /
escitalopram
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基金
北京市东城区优秀人才培养资助项目 (2017-25)
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