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老年单双相抑郁障碍急性期住院患者临床特征 和神经内分泌差异分析
甄文凤马辛张庆娥
()
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目的 探讨急性期老年双相抑郁障碍与单相抑郁障碍患者临床特征、神经内分泌的差 异。方法 回顾性连续纳入2018年6月1日至2019年9月30日于北京安定医院老年病房住院的急性期 单相抑郁障碍患者(单相组,60例)及同期住院的性别、年龄和受教育程度相匹配的双相抑郁障碍患者(双 相组,60例),使用自编调查量表收集两组抑郁患者临床特征、神经内分泌相关指标及汉密尔顿抑郁量 表(HAMD)、简易精神状态检查(MMSE)量表评分,并进行组间单因素分析及多因素Logistic回归分析,分 析老年双相抑郁障碍患者发病的影响因素。结果 双相组患者首发年龄小于单相组[(43.35±16.04)岁 比(54.40±14.36)岁;t=3.975,P<0.01],总病程长于单相组[23.50(11.25,37.25)年比7.00(1.00,16.75)年;Z= -4.301,P<0.01],入院次数大于单相组[2(1,3)次比1(1,1)次;Z=-4.851,P<0.01];双相组发病前多无诱因, 两组差异有统计学意义(P<0.05)。双相组总三碘甲状腺原氨酸(TT3)[(1.25±0.29)nmol/L]、游离三碘甲状 腺原氨酸(FT3)[(4.27±0.60)pmol/L]低于单相组[分别为(1.42±0.29)nmol/L、(4.58±0.67)pmol/L;t值分 别为3.118、2.621,均P<0.05],且TT3异常比例(18.3%)高于单相组(5.0%),差异有统计学意义(P<0.05), 而其余指标两组差异均无统计学意义(均P> 0.05)。多因素 Logistic 回归分析结果显示,发病前无诱因 (OR=0.264,P=0.004,95%CI:0.107~0.651)、入院次数为(OR=2.031,P=0.006,95%CI:1.224~3.371)可能 老年双相抑郁障碍发生的危险因素。结论 急性期老年单、双相抑郁障碍患者存在不同特征,双相患 者首发年龄早、病程长、入院次数多,多无发病诱因,甲状腺功能也存在不同特征,主要表现在 TT3、FT3 差异。发病诱因、入院次数可能是与老年双相抑郁障碍关系较密切的因素,但需要进一步探索分析。
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Difference analysis of clinical characteristics and neuroendocrine of the elderly hospitalized patients with acute bipolar and unipolar depression
Zhen Wenfeng, Ma Xin, Zhang Qing'e
()
Abstract:
Objective To explore the different characteristics of clinical characteristics and neuroendocrine of the elderly hospitalized patients with acute bipolar and unipolar depression. Methods A total of 60 elderly patients with unipolar depression (unipolar group) and sixty patients with bipolar depression (bipolar group), with the same structure of gender, age, and education background were collected from June 1, 2018 to September 30, 2019. Self-made questionnaire was used to collect clinical features, neuroendocrine, and Hamilton Depression Scale (HAMD), and Min-mental State Examination (MMSE). Intergroup univariate analysis and multivariate logistic regression analysis were performed to analyze the influencing factors of the incidence of elder patients with bipolar depression. Results The onset age of patients in the bipolar group [(43.35±16.04) years] was smaller than that of the unipolar group [(54.40±14.36) years]; t=3.975,P< 0.01; The total course of disease was longer than that of the unipolar group [(23.50 (11.25,37.25) years and 7.00 (1.00, 16.75) years; Z=-4.301,P< 0.01]. The number of hospital admissions was greater than that of the unipolar group [(2(1, 3)

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