天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (12): 1275-1278.doi: 10.11958/20170731

• 临床研究 • 上一篇    下一篇

难治性抑郁症与首发抑郁症患者认知功能的对比研究

简炜颖 1， 关力杰 1， 黄建伟 2， 苏婵 3   

  1. 基金项目： 广州市医学卫生科技项目 （20151A010066） 作者单位： 1 广州医科大学附属脑科医院， 广州市惠爱医院情感障碍科 （邮编 510370）， 2 放射科， 3 老年科 作者简介： 简炜颖 （1982）， 女， 本科， 副主任医师， 主要从事抑郁症及双相情感障碍的研究
  • 收稿日期:2017-06-23 修回日期:2017-10-11 出版日期:2017-12-15 发布日期:2017-12-15
  • 通讯作者: 简炜颖 E-mail:jw_jiangjw@126.com
  • 基金资助:
    广州市医学卫生科技项目

A control study of cognitive function in patients with treatment-resistant depression and first-episode depression

JIAN Wei-ying1, GUAN Li-jie1, HUANG Jian-wei2, SU Chan3   

  1. 1 Department of Affective Disorders, 2 Department of Radiology, 3 Department of Geriatrics, the Brain Affiliated Hospital of Guangzhou Medical University, Guangzhou 510370, China
  • Received:2017-06-23 Revised:2017-10-11 Published:2017-12-15 Online:2017-12-15

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摘要： 目的 比较难治性抑郁症患者与首次发作抑郁症患者认知功能的损害差异。方法 收集 2015 年 3 月— 2016 年 12 月间我院收治的重性抑郁障碍患者 80 例， 其中难治性抑郁症 （难治性抑郁组） 和首次发作抑郁症 （首发抑 郁组）患者各 40 例， 另选取 40 例健康志愿者作为正常对照组。收集患者的基本资料， 采用汉密尔顿抑郁评定量表 （17 项， HAMD-17） 评估疾病严重程度。用连线测验和 stroop 色词测验评估执行能力； 数字广度测验评估注意力； 霍 普金斯词语学习测验修订版 （HVLT-R） 评估记忆力。对首发抑郁症组连续药物治疗 6 个月后， 再次行临床评估和认 知功能测试。结果 与正常对照组相比， 首发抑郁组和难治性抑郁组连线测验时间升高， 而数字广度测验、 色词测 验和 HVLT-R 评分降低（P < 0.05）。首发抑郁组连线测验时间、 HAMD-17 评分较难治性抑郁组降低（P < 0.05）， 其 他指标差异无统计学意义。首发抑郁组治疗后连线测验时间和 HAMD-17 评分较治疗前降低， 而数字广度评分、 色 词测验-单词、 色词测验-色词和 HVLT-R 评分较治疗前增高（P < 0.05）， 认知功能明显改善。结论 难治性抑郁症 和首发抑郁症患者均有明显的认知功能损害， 但两者的严重程度无明显差别。

关键词: 抑郁症, 认知, 难治性抑郁症, 首发抑郁症, 17 项汉密尔顿抑郁评定量表

Abstract: Objective To compare the cognitive functions between patients with treatment-resistant depression and first-episode depression. Methods A total of 80 major depressive disorder patients admitted in our hospital from March 2015 to December 2016 were included in this study. The patients were divided into treatment-resistant depression group (n= 40) and first-episode depression group (n=40). Another 40 healthy individuals were used as the control group. The basic data of patients were collected, and Hamilton depression scale (HAMD)- 17 was used to assess the severity of the disease. The performing functions were assessed by trail marking test and stroop color-word test. The attention functions were assessed by digital span test. Memory functions were assessed by Hopkins verbal learning test revise (HVLT-R). After treatment for 6 months, cognitive functions were assessed again in first-episode depression group. Results Compared with control group， the scores of trail marking test (TMT) increased, while the scores of digital span test, stroop color-word test, stroop color colorword test, HVLT-R reduced in treatment-resistant depression group and first-episode depression group (P < 0.05). The scores of TMT, HAMD-17 were lower in first-episode depression group than those of treatment-resistant depression group (P < 0.05). There were no significant differences in other indexes between groups. After six months treatment, the trail marking test score and HAMD-17 reduced, but digital span test, stroop color-word test increased in first-episode depression group (P < 0.05). Conclusion The cognitive function damages severely in patients with treatment-resistant depression and first-episode depression, but there is no obvious difference in severity between two groups of patients.

Key words: depressive disorder, cognition, treatment-resistant depression, first-episode depression, HAMD-17