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康复期抑郁症患者的激发性内分泌检测

Provocative endocrine testing in recovered depressives.

作者信息

Kathol R G, Winokur G, Sherman B M, Lewis D, Schlesser M

出版信息

Psychoneuroendocrinology. 1984;9(1):57-67. doi: 10.1016/0306-4530(84)90022-2.

Abstract

Twenty-eight patients underwent a series of provocative endocrine tests an average of one year after their last admission for depression. Hypersecretion of cortisol, early escape of cortisol from dexamethasone suppression, diminished growth hormone response to insulin-induced hypoglycemia and altered thyrotropin response to thyrotropin-releasing hormone reported in acute primary depression were not observed after recovery. There were no differences in these measures after recovery between previous suppressors and nonsuppressors to dexamethasone. The cortisol response to insulin-induced hypoglycemia was less than expected in 6 of 16 recovered patients tested. There were significant differences in post-dexamethasone urinary free cortisol and in basal and early post-insulin serum cortisol levels between patients who had been suppressors and those who had been nonsuppressors to dexamethasone during acute depression. Further studies need to be done to substantiate these findings. These data indicate that hormone responses in recovered depressives are largely normal, suggesting that abnormalities during depression are "state" related phenomena.

摘要

28名患者在最后一次因抑郁症入院平均一年后接受了一系列激发性内分泌测试。在恢复后未观察到急性原发性抑郁症中所报告的皮质醇分泌过多、皮质醇从地塞米松抑制中早期逃逸、生长激素对胰岛素诱导的低血糖反应减弱以及促甲状腺激素对促甲状腺激素释放激素反应改变的情况。在恢复后,之前对地塞米松有抑制反应者和无抑制反应者在这些指标上没有差异。在接受测试的16名康复患者中,有6名对胰岛素诱导的低血糖的皮质醇反应低于预期。在急性抑郁症期间对地塞米松有抑制反应者和无抑制反应者之间,地塞米松后尿游离皮质醇以及基础和胰岛素注射后早期血清皮质醇水平存在显著差异。需要进一步研究来证实这些发现。这些数据表明,康复抑郁症患者的激素反应在很大程度上是正常的,这表明抑郁症期间的异常是“状态”相关现象。

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