抑郁症患者儿童期受虐对单胺类神经递质及相关因素的影响

目的：探索抑郁症患者儿童期受虐对血清5．羟色胺（5-hydroxytryptamine5-HT）、多巴胺（Dopamine DA）和去甲肾上腺素（Norepinephrine NE）水平及相关因素的影响。方法：对101例抑郁症患者采用儿童受虐问卷（CTQ）、24项汉密尔顿抑郁量表（HAMD24）、自杀意念量表（SIOSS）及Beck绝望量表（BHS）评定儿童期受虐程度，抑郁严重程度，自杀意念强度和绝望严重程度。采用酶联免疫吸附法（ELLSA）测定血清5-HT、DA和NE水平。根据CTQ评分将总分≥50分，分量表≥10分定为被虐待。结果：（1）情感忽视组血清5-HT和DA水平明显低于无忽视组（35．63±62．43，62．58±79．50；P〈0．05；4．08±6．30ng／1，7．61±11．47ng／1，P〈0．05），受虐组血清NE水平虽高于无受虐组但无统计学意义；（2）情感受虐组和躯体受虐组的HAMD24评分明显高于无受虐组（30．60±9．84，26．77±6．54P〈0．05；31．00±9．59，27．79±8．23；P〈0．05）．遭受性虐待组SIOSS评分明显高于无虐待组（17．07±3．29，14．26±3．63，P〈0．01）。情感受虐组BHS评分明显高于无受虐组（12．13±3．32，10．35±4．30，P〈0．05）（3）儿童期情感被忽视和躯体被虐待评分与BHS评分呈明显正相关（r=0．22，r=0．23，P〈0．05），被性虐待程度与SIOSS评分有明显相关（r=0．35，P〈0．01）。结论：儿童期情感被忽视的抑郁症患者血清5-HT和DA水平偏低，儿童期受虐的抑郁症患者可能存在下丘脑-垂体-肾上腺轴的不稳定。儿童期受虐是抑郁发作的危险因素并有更严重的抑郁症状。

Analysis of the Childhood Abuse with Monoamine Neurotransmitters and Related Factors in Depressive Patients

Objective： To investigate the effects of serum 5-hydroxytryptamine （5-HT）, Dopamine （DA）, Norepinephrine （ NE ） levels and childhood abuse in depressive patients. Methods： 101 depressive patients were tested by the childhood Trauma Questionnaire; （CTQ）; Hamilton Depression Rating Scaleitems （HAMD24）; self-rating idea of suicide scale （SIOSS） and Beck Helpless Rating Scale （BHS） to evaluate the severity of symptoms.The serum5-HT, DA, NE levels were measured by enzyme-linked immnnosorbent assay （ELISA）. According to the scores of CTQ, the total score ≥ 50 and branched of watch rating ≥10 were difined as the abuse group. Results： （1） The serum 5-HT, DA level in emotion neglect Group was lower than that in non-neglect （35.63± 62.43, 62.58± 79.50; P〈 0.05; 4.08± 6.30ng/1,7.61± 11.47ng/1, P〈0.05）. The serum NE level in abuse groups was higher than that in non-abuse but not statistical sig- nificant. （2） The HAMD24 score in emotion abuse and physical abuse group （30.60± 9.84, 31.00-1- 9.59） was higher than that in non-abuse（26.77± 6.54, 27.79± 8.23, P〈0.05）. The sexual abuse group of SIOSS score was higher than that in non-abuse（17.07± 3.29, 14.26± 3.63, P〈0.01）. The BHS score with emotion abuse group was higher than that in non-abuse （12.13：1： 3.32,10.35± 4.30, P〈 0.05）. （3） Emotion neglect and physical abuse group was significantly correlated with BHS （r=0.22, r=0.23, P〈0.05）, sexual abuse group was significantly correlated with SIOSS （ r=0.35, P〈0.01）. Conclusion： The serum 5-HT, DA level was lower in emotion neglect with depres- sive patients.The childhood abuse may be present instability of the hypothalamus-pituitary-adrenal （HPA） axis in depression. The child abuse is a risk factor in deepressive episode and makes symptoms more serious.