文章摘要
洪虹,孔晓明,张丽,等.老年抑郁症共病阻塞性睡眠呼吸暂停低通气综合征与血脂、抑郁焦虑症状的关系[J].安徽医药,2020,24(4):696-699.
老年抑郁症共病阻塞性睡眠呼吸暂停低通气综合征与血脂、抑郁焦虑症状的关系
Association of obstructive sleep apnea hypopnea syndrome with blood lipid,depression and anxiety in elderly patients with depression
  
DOI:10.3969/j.issn.1009?6469.2020.04.015
中文关键词: 抑郁症  睡眠呼吸暂停,阻塞性  胆固醇  三酰甘油类  胆固醇, HDL  脂蛋白类, LDL  老年人
英文关键词: Depressive disorder  Sleep apnea,obstructive  Cholesterol  Triglycerides  Cholesterol,HDL  Lipoproteins,LDL  Aged
基金项目:安徽省高校自然科学研究项目重点项目( KJ2018A0196);合肥市卫计委应用医学研究项目( hwk2017yb15)
作者单位E-mail
洪虹 合肥市第四人民医院、安徽省精神卫生中心、安徽医科大学附属心理医院老年心理科一病区安徽合肥 230022  
孔晓明 合肥市第四人民医院、安徽省精神卫生中心、安徽医科大学附属心理医院老年心理科一病区安徽合肥 230022 kxm186@163.com 
张丽 合肥市第四人民医院、安徽省精神卫生中心、安徽医科大学附属心理医院老年心理科一病区安徽合肥 230022  
孙艳 安徽医科大学附属第一医院老年内分泌科安徽合肥 230022  
陈领 合肥市第四人民医院、安徽省精神卫生中心、安徽医科大学附属心理医院老年心理科一病区安徽合肥 230022  
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中文摘要:
      目的探讨老年抑郁症病人阻塞性睡眠呼吸暂停低通气综合征( obstructive sleep apnea hypopnea syndrome,OSAHS)与血脂及抑郁、焦虑症状的相关性。方法选取 2016年 1月至 2019年 8月安徽省精神卫生中心住院的老年抑郁症病人 60例,根据是否存在 OSAHS,分成抑郁症伴阻塞性睡眠呼吸暂停低通气综合征组( DEP?O组, 30例)和抑郁症无阻塞性睡眠呼吸暂停低通气综合征组( DEP?N组, 30例)选取年龄、性别相匹配健康体检者 30例作为健康对照组。测量三组总胆固醇( TC)、三酰甘油(TG)、高密度脂蛋白( HDL?C)和低,密度脂蛋白( LDL?C)采用汉密尔顿抑郁量表( HAMD?24)和汉密尔顿焦虑量表( HAMA)评定三组抑郁、焦虑症状程度。结果三组在 TC、HDL?C和,LDL?C差异有统计学意义;采用 LSD法进行两两比较,结果显示, DEP?O组 TC(4.88±0.91)mmol/L、LDL?C(2.89±0.78)mmol/L高于 DEP?N组( 4.42±0.67)mmol/L、(2.43±0.57)mmol/L(P<0.05), HDL?C(1.30±0.28)mmol/L低于健康对照组( 1.54±0.31)(P<0.01)LDL?C高于健康对照组( P<0.05); DEP?N组 TC(4.42±0.67) mmol/L、HDL?C(1.35±0.34)mmol/L低于健康对照组( P<0.05);三组的,HAMD、HAMA评分差异有统计学意义,采用 LSD法进行两两比较,结果显示, DEP?O组的 HAMD(27.10±6.26)分、 HAMA(18.83±6.27)分高于 DEP?N组和对照组( P<0.05); DEP?O组中 HAMD、HAMA均与 AHI呈正相关( P<0.05)HAMA与 TC、LDL?C呈正相关( P<0.05)。结论 OSAHS对老年抑郁症病人的血脂代谢有影响,主要表现在 TC、LDL?C的升高,,不论有无 OSAHS,老年抑郁症病人的 HDL?C水平都低于健康对照组,伴有 OSAHS的老年抑郁症病人有更严重的抑郁、焦虑症状,且与 TC、LDL?C升高以及呼吸暂停的严重程度有关。
英文摘要:
      Objective To investigate the correlation of obstructive sleep apnea hypopnea syndrome(OSAHS)with blood lipid,de? pression and anxiety in geriatric depression patients.Methods Sixty cases of geriatric patients with depression,who were hospital? ized in Anhui Mental Health Center from January 2016 to August 2019 were assigned,according to the presence of OSAHS or not, into depression complicated with obstructive sleep apnea hypopnea syndrome group(DEP?O group,30 cases)and depression not complicated with obstructive sleep apnea hypopnea syndrom group(DEP?N group,30 cases),and 30 healthy subjects having physi? cal examination with matched age and gender were chosen as control group.Total cholesterol(TC),triglyceride(TG),high?density lipoprotein(HDL?C)and low?density lipoprotein(LDL?C)in the three groups were measured,and the depression and anxiety symptoms of the three groups were assessed by Hamilton depression rating scale(HAMD?24)and Hamilton anxiety rating scale(HAMA).Results There were statistically significant differences in TC,HDL?C and LDL?C among the three groups.LSD method was used for pairwise comparison,and the results showed that TC and LDL?C levels in the DEP?O group were higher than those in the DEP?N group[(4.88±0.91)mmol/L vs.(4.42±0.67)mmol/L,(2.89±0.78)mmol/L vs.(2.43±0.57)mmol/L;P<0.05].HDL?C level in DEP?O group was lower than that in the normal control group[(1.30±0.28)mmol/L vs.(1.54±0.31),P<0.01],and LDL?C level in DEP?O group was higher than that in the normal control group(P<0.05).TC and HDL?C levels in DEP?N group were low? er than those in the normal control group[( 4.42±0.67)mmol/L,(1.35±0.34)mmol/L,respectively;P<0.05].HAMD and HA? MA scores of the three groups showed statistically significant differences.LSD method was used for pairwise comparison,and the re? sults showed that HAMD(27.10±6.26)and HAMA(18.83±6.27)scores of the DEP?O group were higher than those of the DEP?N group and the normal control group(P<0.05).In the DEP?O group,HAMD and HAMA were positively correlated with AHI(P< 0.05),and HAMA was positively correlated with TC and LDL?C(P<0.05).Conclusions OSAHS has influence on the blood lipid metabolism in elderly patients with depression,mainly manifested in the increase of TC,LDL?C.Regardless of the presence of OSAHS,in elderly patients with depression HDL?C level is lower than that of the normal control group.Geriatric patients with de?pression accompanied by OSAHS have more severe depression and anxiety symptoms,which are related to the increase of TC,LDL? C and the severity of apnea.
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