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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2022, Vol. 16 ›› Issue (08) : 732 -737. doi: 10.3877/cma.j.issn.1674-0785.2022.08.005

心身医学·临床研究

度洛西汀对抑郁障碍患者骨代谢影响的对照研究
徐晓燕1, 林邹卿2, 张凯3, 查智群4, 易峰4, 曹磊明2, 陈新宇2(), 王国强2,†()   
  1. 1. 214100　江苏无锡，南京医科大学附属无锡精神卫生中心临床心理科；214100　江苏无锡，无锡市中医医院临床心理科
    2. 214100　江苏无锡，南京医科大学附属无锡精神卫生中心临床心理科
    3. 23800　合肥，安徽医科大学附属巢湖医院精神科
    4. 214100　江苏无锡，无锡市中医医院临床心理科
  • 收稿日期:2022-04-17 出版日期:2022-08-15
  • 通信作者: 陈新宇, 王国强
  • 基金资助:
    无锡市卫生与计划生育委员会重大项目(Z201605)

Comparative study of effect of duloxetine on bone metabolism in patients with depressive disorder

Xiaoyan Xu1, Zouqing Lin2, Kai Zhang3, Zhiqun Cha4, Feng Yi4, Leiming Cao2, Guoqiang Wang2,†()   

  1. 1. Department of Clinical Psychology, Wuxi Mental Health Center, Nanjing Medical University, Wuxi 214100, China; Department of Psychiatry, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214100, China
    2. Department of Clinical Psychology, Wuxi Mental Health Center, Nanjing Medical University, Wuxi 214100, China
    3. Department of Psychiatry, Chaohu Hospital Affiliated to Anhui Medical University, Hefei 23800, China
    4. Department of Psychiatry, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214100, China
  • Received:2022-04-17 Published:2022-08-15
  • Corresponding author: Guoqiang Wang
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引用本文：

徐晓燕, 林邹卿, 张凯, 查智群, 易峰, 曹磊明, 陈新宇, 王国强. 度洛西汀对抑郁障碍患者骨代谢影响的对照研究[J]. 中华临床医师杂志(电子版), 2022, 16(08): 732-737.

Xiaoyan Xu, Zouqing Lin, Kai Zhang, Zhiqun Cha, Feng Yi, Leiming Cao, Guoqiang Wang. Comparative study of effect of duloxetine on bone metabolism in patients with depressive disorder[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(08): 732-737.

目的

采用骨转化标志物的血浓度比较，评估抗抑郁药物度洛西汀对抑郁障碍患者骨代谢的影响。

方法

使用病例-正常对照、治疗前后对照的方法，于2020年9月至2022年2月，在无锡市中医医院临床心理科和无锡市精神卫生中心临床心理科招募抑郁障碍患者（患者组）49例和性别年龄相匹配的健康对照组（对照组）49例，以及患者组使用度洛西汀治疗前后比较。采用电化学发光免疫分析法，检测血液骨转化标志物1型胶原c-端交联末端肽（β-CTX）和1型前胶原n-前肽（P1NP）浓度。

结果

在基线时，2组β-CTX（pg/ml）存在统计学差异，患者组显著高于正常组［321.1（189.4）vs 210.4（103.5），t=-3.59，P=0.001］，而P1NP（ng/ml）没有统计学差异（P＞0.05）。患者组经治疗，β-CTX从321.1（189.4）显著性升高为475.3（192.4）（P=0.001），P1NP从49.9（19.8）虽然升高为54.5（27.6），但差异没有统计学意义（P＞0.05）。

结论

抑郁障碍患者比对照组骨吸收增加，经度洛西汀治疗后骨吸收更明显，可能会增加骨折风险。

关键词: 抑郁障碍, 度洛西汀, 骨转化标志物
Objective

To evaluate the effect of the antidepressant duloxetine on bone metabolism in patients with depression by comparing the blood concentration of bone turnover markers.

Methods

From September 2020 to February 2022, 49 patients with depressive disorder (patient group) and 49 sex- and age-matched healthy controls (normal group) were recruited at the Department of Clinical Psychology of Wuxi Hospital of Traditional Chinese Medicine and the Department of Clinical Psychology of Wuxi Mental Health Center. Blood concentrations of bone transformation markers including C-terminal cross-linking telopeptide of type I collagen (β-CTX) and N-terminal propeptide of type I procollagen (P1NP) were detected by electrochemiluminescence immunoassay. Comparisons were performed between the patient group and the normal group, and between patients before and after treatment with duloxetine.

Results

At baseline, β-CTX (pg/ml) was significantly higher in the patient group than in the normal group [321.1 (189.4) vs 210.4 (103.5), t=-3.59, P=0.001], but there was no significant difference in P1NP (P＞0.05). After treatment, β-CTX increased significantly from 321.1 (189.4) to 475.3 (192.4) in the patient group (P=0.001); P1NP increased from 49.9(19.8) to 54.5(27.6), but there was no significant difference.

Conclusion

Bone resorption in patients with depression is higher than that in healthy people, and it is more obvious after treatment with duloxetine, which may increase the risk of fracture.

Key words: Depressive disorder, Duloxetine, Bone turnover marker
表1 2组被试基本信息比较
项目 患者组（n=49） 对照组（n=49） t/χ2值 P值
男/女 18/31 26/23 2.64 0.104
年龄（岁） 29.65（7.50） 31.85（6.22） -1.58 0.116
表2 患者组和对照组各阶段β-CTX、P1NP结果
分组 时间点
基线 4周末 8周末
患者组（n=49）
β-CTX（pg/ml） 321.1（189.4） 411.9（196.7） 475.3±192.4
P1NP（ng/ml） 49.9（19.8） 65.2（44.3） 54.5±27.6
对照组（n=49）
β-CTX（pg/ml） 210.4（103.5） - -
P1NP（ng/ml） 52.3（36.6） - -
图1 患者组与对照组β-CTX表达比较 注：β-CTX为1型胶原的c-端交联末端肽；横轴代表对照组和患者组在基线、4周末和8周末的检测时间；竖轴代表β-CTX含量水平（pg/ml）；*代表差异程度
图2 患者组与对照组P1NP表达比较 注：P1NP为1型前胶原n-前肽，横轴代表对照组和患者组在基线、4周末和8周末的检测时间；竖轴代表P1NP含量水平（ng/ml）
图3 患者组基线时β-CTX与P1NP的相关分析 注：β-CTX为1型胶原的c-端交联末端肽；P1NP为1型前胶原n-前肽
图4 患者组8周末时β-CTX与P1NP的相关分析 注：β-CTX为1型胶原的c-端交联末端肽；P1NP为1型前胶原n-前肽
图5 患者组基线时β-CTX与HAMD-24的相关分析 注：β-CTX为1型胶原的c-端交联末端肽；HAMD-24为24项汉密尔顿抑郁评定量表
图6 患者组4周末时P1NP与HAMD-24的相关分析 注：P1NP为1型胶原的c-端交联末端肽；HAMD-24为24项汉密尔顿抑郁评定量表
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