早发性抑郁症患者与晚发性抑郁症患者AD7c-NTP水平和认知功能的研究

戴宇凌; 王小泉; 王祖森; 宋传福; 张军; 朱文礼; 蔡菡; 王定祥; 许亮; 杨涛

doi:10.16766/j.cnki.issn.1674-4152.003796

早发性抑郁症患者与晚发性抑郁症患者AD7c-NTP水平和认知功能的研究

doi: 10.16766/j.cnki.issn.1674-4152.003796

1.
皖南医学院人文与管理学院，安徽芜湖 241002
2.
首都医科大学附属北京安定医院芜湖医院老年精神科，安徽芜湖 241000
3.
首都医科大学附属北京安定医院芜湖医院检验科

基金项目:

安徽省临床医学研究转化专项项目 202204295107020065

安徽省芜湖市卫健委科研项目 WHWJ2022z018

安徽省芜湖市科技计划项目 2022cg31

安徽省芜湖市第四人民医院院内课题 kjxm202206

详细信息

通讯作者:
王小泉，E-mail：1073018189@qq.com

中图分类号: R749.4
计量
- 文章访问数: 9
- HTML全文浏览量: 9
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2023-12-30
- 网络出版日期: 2025-01-20

Analysis of AD7c-NTP levels and cognitive function in patients with early-onset depression and late-onset depression

1.
School of Humanities and Management, Wannan Medical College, Wuhu, Anhui 241002, China

摘要

摘要: 目的分析早发性抑郁症患者与晚发性抑郁症患者及健康老年人在AD7c-NTP水平和认知功能上的差异，为老年抑郁症临床诊断提供参考。方法选取首都医科大学附属北京安定医院芜湖医院精神科于2022年1月—2024年1月收治的174例老年抑郁症患者为研究对象，根据首次发病的年龄进行分组，将首次发作年龄＜60岁的抑郁症患者作为早发组(EOD, 105例)，首次发作年龄≥60岁的抑郁症患者作为晚发组(LOD, 69例)。将在该院体检、病人陪护及社区医院体检的75例老年人作为健康对照组(NC, 75例)。对所有受试者采用ELISA法检测尿AD7c-NTP水平，以蒙特利尔认知评估量表(MoCA)评估各组对象的认知功能，比较EOD组、LOD组、NC组的认知功能和AD7c-NTP值的差异，对MoCA与尿液AD7c-NTP值之间进行Spearman相关分析。结果 EOD组、LOD组和NC组认知功能、AD7c-NTP水平差异均有统计学意义(P < 0.01)。3组研究对象的认知水平与尿液AD7c-NTP水平均呈负相关关系(P＜0.01)。此外，EOD组的抑郁水平与AD7c-NTP不相关(P=0.799), LOD组的抑郁水平与AD7c-NTP不相关(P=0.635)。结论晚发性抑郁症患者AD7c-NTP水平增高，注意力和执行功能等方面的认知功能缺陷。AD7c-NTP水平与抑郁程度无相关性。AD7c-NTP水平与认知功能呈负相关关系，AD7c-NTP水平可作为老年人认知功能变化的预测工具。
- 早发性抑郁症 /
- 晚发性抑郁症 /
- AD7c-NTP /
- 认知功能 /
- 老年抑郁症
Abstract: Objective To analyze the differences in AD7c-NTP levels and cognitive function among patients with early-onset depression, late-onset depression, and healthy elderly individuals, providing insights for the clinical diagnosis of geriatric depression. Methods A total of 174 elderly patients with depression admitted to Wuhu Hospital, Beijing An'ding Hospital Affiliated to Capital Medical University from January 2022 to January 2024 were selected as the study objects. Based on the age of first onset, depression patients were categorized into the early onset group (EOD, n=105; first onset < 60 years) and the late onset group (LOD, n=69; ≥ 60 years). A control group of seventy-five healthy elderly patients (NC, n=75) were selected from hospital check-ups and community hospital centers. Urinary AD7c-NTP levels of all subjects were detected by ELISA, and the cognitive function of each group was assessed by Montreal cognitive assessment scale (MoCA). AD7c-NTP values and cognitive function scores were compared across the EOD, LOD, and NC groups. Spearman correlation analysis was performed to evaluate the relationship between MoCA scores and urine AD7c-NTP values. Results Significant differences in cognitive function and AD7c-NTP levels were observed among the EOD, LOD, and NC groups (P < 0.01). The cognitive levels were negatively correlated with urine AD7c-NTP levels in all groups (P < 0.01). In addition, depression levels were not associated with AD7c-NTP in the EOD group (P=0.799) and were not associated with AD7c-NTP in the LOD group (P=0.635). Conclusion The AD7c-NTP levels are significantly increased in patients with late-onset depression, who also exhibit cognitive deficits in attention and executive function. While AD7c-NTP levels were not associated with depression severity, they were negatively correlated with cognitive function. AD7c-NTP level can serve as a predictive biomarker for detecting cognitive changes in the elderly.
- Early-onset depression /
- Late-onset depression /
- AD7c-NTP /
- Cognitive function /
- Senile depression

HTML全文

表 1 3组研究对象一般临床资料比较

Table 1. Comparison of general clinical data among the three groups

组别	例数	性别 (男/女，例)	年龄 (x±s，岁)	教育年限 [M(P₂₅, P₇₅)，年]	家族史 (无/有，例)	有无诱因 (有/无，例)	起病形式 (急/慢，例)	病程 [M(P₂₅, P₇₅)，月]
EOD组	105	26/79	63.62±5.31	6.00(0.00, 9.00)	0/105	37/68	31/74	120(48.00, 249.00)
LOD组	69	17/52	69.81±5.55	6.00(0.00, 9.00)	2/67	29/40	27/42	17(9.00, 60.00)
NC组	75	49/26	69.68±5.28	9.00(6.00, 9.00)
统计量		18.028^a	39.377^b	18.586^c	164.090^a	7.448^a	19.333^a	41.676^d
P值		＜0.001	＜0.001	＜0.001	＜0.001	0.001	＜0.001	＜0.001
注：^a为χ²值，^b为F值，^c为H值，^d为Z值。

下载: 导出CSV

表 2 3组研究对象认知功能各维度比较[M(P₂₅, P₇₅)，分]

Table 2. Comparison of cognitive functions among the three groups [M(P₂₅, P₇₅), points]

组别	例数	执行功能	命名	记忆	注意	语言	抽象功能	定向力	MoCA总分
EOD组	105	3.00(1.00, 4.00)^ab	2.00(1.00, 2.00)	1.00(0.00, 1.00)	5.00(3.00, 6.00)^ab	1.00(1.00, 2.00)^ab	0.00(0.00, 1.00)	4.00(4.00, 6.00)^ab	17.00(14.00, 21.00)^ab
LOD组	69	1.00(0.00, 1.50)^a	2.00(1.00, 2.00)	1.00(0.00, 1.00)	4.00(2.00, 6.00)^a	1.00(1.00, 2.00)^a	0.00(0.00, 0.00)	5.00(4.00, 6.00)^a	15.00(11.00, 18.00)^a
NC组	75	3.00(2.00, 4.00)	3.00(1.00, 3.00)	1.00(0.00, 3.00)	6.00(5.00, 6.00)	2.00(1.00, 2.00)	0.00(0.00, 1.00)	6.00(6.00, 6.00)	21.00(18.00, 24.00)
H值		64.034	9.236	7.408	31.058	12.498	4.024	52.982	56.483
P值		＜0.001	0.010	0.025	＜0.001	0.002	0.134	＜0.001	＜0.001
注：与NC组比较, ^aP＜0.01;与LOD组比较, ^bP＜0.01。

下载: 导出CSV

表 3 3组研究对象AD7c-NTP水平、MoCA总分、HAMD总分比较

Table 3. Comparison of AD7c-NTP level, total score of MoCA and total score of HAMD among the three groups

组别	例数	AD7c-NTP水平 [M(P₂₅, P₇₅)，ng/mL]	MoCA总分 [M(P₂₅, P₇₅)，分]	HAMD总分 (x±s，分)
EOD组	104	0.430(0.110, 0.760)^ab	17.00(14.00，21.00)^ab	33.85±5.72^ab
LOD组	96	0.870(0.315, 1.765)^a	15.00(11.00，18.00)^a	33.13±6.08^a
NC组	75	0.310(0.220, 0.410)	21.00(18.00，24.00)	5.60±1.64
统计量		25.384^c	56.483^c	822.982^d
P值		＜0.001	< 0.001	＜0.001
注：与NC组比较, ^aP < 0.01；与LOD组比较, ^bP < 0.01。^c为H值，^d为F值。

下载: 导出CSV

表 4 3组研究对象AD7c-NTP水平与HAMD评分、认知功能的相关性分析

Table 4. Correlation analysis between AD7c-NTP level, HAMD score and cognitive function among the three groups

项目	EOD组		LOD组		NC组
项目	r值	P值	r值	P值	r值	P值
HAMD总分	-0.025	0.799	0.058	0.635	-0.029	0.806
MMSE总分	-0.421	＜0.001	-0.387	0.001	-0.166	0.154
MoCA总分	-0.675	＜0.001	-0.699	＜0.001	-0.383	0.001
执行功能维度评分	-0.466	＜0.001	-0.486	＜0.001	-0.290	0.012
命名维度评分	-0.441	＜0.001	-0.336	0.005	-0.177	0.129
记忆力维度评分	-0.361	＜0.001	-0.289	0.016	-0.269	0.020
注意力维度评分	-0.520	＜0.001	-0.582	＜0.001	-0.176	0.131
语言维度评分	-0.230	0.018	-0.183	0.132	-0.259	0.025
抽象能力维度评分	-0.217	0.026	-0.185	0.128	-0.222	0.055
定向力维度评分	-0.388	＜0.001	-0.384	0.001	-0.284	0.014

下载: 导出CSV

参考文献(27)

[1]	赖桂香. 度洛西汀与舍曲林治疗老年抑郁症患者的临床效果及安全性比较[J]. 中国医药指南, 2024, 22(2): 73-75. LAI G X. Comparison of clinical efficacy and safety of Duloxetine and Sertraline in the treatment of elderly patients with depression[J]. Guide of China Medicine, 2024, 22(2): 73-75.
[2]	KAMALZADEH L, SAGHAFI M, MORTAZAVI S S, et al. Vitamin D deficiency and depression in obese adults: a comparative observational study[J]. BMC Psychiatry, 2021, 21(1): 599. doi: 10.1186/s12888-021-03586-4
[3]	张晓娟, 邓祥瑞, 陈睿, 等. 老年抑郁症人群认知功能损害与微血管功能障碍的关系[J]. 中国实用神经疾病杂志, 2023, 26(12): 1559-1564. ZHANG X J, DENG X R, CHEN R, et al. Relationship between cognitive impairment and microvascular dysfunction in elderly patients with depression[J]. Chinese Journal of Practical Nervous Diseases, 2023, 26(12): 1559-1564.
[4]	查倩倩, 徐莲英, 孔晓明, 等. 老年抑郁症住院患者复发影响因素的回顾性分析[J]. 中国健康心理学杂志, 2022, 30(3): 326-329. ZHA Q Q, XU L Y, KONG X M, et al. Retrospective analysis of factors affecting relapse in elderly patients with depression[J]. China Journal of Health Psychology, 2022, 30(3): 326-329.
[5]	施于超, 胡卫红, 白丽, 等. 血清ghrelin、NLRP3对老年抑郁症患者认知功能损害的诊断价值分析[J]. 现代生物医学进展, 2023, 13(23): 2460-2465. SHI Y C, HU W H, BAI L, et al. Diagnostic value of serum ghrelin and NLRP3 in cognitive impairment of elderly patients with depression[J]. Progress in Modern Biomedicine, 2023, 13(23): 2460-2465.
[6]	ORGETA V, LEUNG P, DEl-PINO-CASADO R, et al. Psychological treatments for depression and anxiety in dementia and mild cognitive impairment[J]. Cochrane Database Syst Rev, 2022, 4(4): CD009125. DOI: 10.1002/14651858.CD009125.
[7]	GAO P, WANG T, WANG D, et al. Effect of stenting plus medical therapy vs medical therapy alone on risk of stroke and death in patients with symptomatic intracranial stenosis: the CASSISS randomized clinical trial[J]. JAMA, 2022, 328(6): 534-542. doi: 10.1001/jama.2022.12000
[8]	HUANG Y Y, CHEN S D, LENG X Y, et al. Post-stroke cognitive impairment: epidemiology, risk factors, and management[J]. J Alzheimers Dis, 2022, 86(3): 983-999. doi: 10.3233/JAD-215644
[9]	杨洁, 朱雪泉. 首发抑郁症患者主观认知功能对其社会功能改善的影响[J]. 神经疾病与精神卫生, 2023, 23(12): 854-858. YANG J, ZHU X Q. The effect of subjective cognitive function on the improvement of social function in patients with first episode depression[J]. Journal of Neuroscience and Mental Health, 2023, 23(12): 854-858.
[10]	庞敬涛, 刘娟, 孙丽, 等. 痰浊蒙窍型轻度认知功能障碍(MCI)的认知损害特点及血清Hcy、GHb、尿AD7c-NTP表达水平相关性研究[J]. 实用中医内科杂志, 2022, 36(9): 123-125. PANG J T, LIU J, SUN L, et al. Study on the characteristics of cognitive impairment and correlation of serum Hcy, GHb and urinary AD7c-NTP expression levels in mild cognitive dysfunction (MCI) with phlegm turbopourexia[J]. Journal of Practical traditional Chinese Internal Medicine, 2022, 36(9): 123-125.
[11]	辛雁瑞, 王佃晖, 王荔. 阿尔茨海默病患者AD7c-NTP和GRK5与认知障碍的相关性[J]. 山西医科大学学报, 2023, 54(11): 1524-1528. XIN Y R, WANG D H, WANG L. Correlation between AD7c-NTP and GRK5 and cognitive impairment in patients with Alzheimer's disease[J]. Journal of Shanxi Medical University, 2023, 54(11): 1524-1528.
[12]	世界卫生组织. 疾病和有关健康问题的国际统计分类ICD10[M]. 北京: 人民卫生出版社, 1996. World Health Organization. International Statistical Classification of Diseases and Related Health Problems ICD10[M]. Beijing: People's Medical Publishing House, 1996.
[13]	何声来, 张旭. 中西医结合疗法治疗阿尔茨海默病疗效及对尿AD7c-NTP水平的影响[J]. 现代中西医结合杂志, 2022, 31(3): 397-401. HE S L, ZHANG X. Effect of integrated Chinese and Western medicine on the treatment of Alzheimer's disease and its influence on urinary AD7c-NTP level[J]. Modern Journal of Integrated traditional Chinese and Western Medicine, 2022, 31(3): 397-401.
[14]	DE LA MONT S M, CARLSON R I, BROWN N V, et al. Profiles of neuronal thread protein expression in Alzheimer's disease[J]. J Neuropathol Exp Neurol, 1996, 55(10): 1038-1050. doi: 10.1097/00005072-199655100-00004
[15]	MA L, WANG R, HAN Y, et al. Development of a novel urine alzheimer-associated neuronal thread protein ELISA kit and its potential use in the diagnosis of Alzheimer's disease[J]. J Clin Lab Anal, 2016, 30(4): 308-314. doi: 10.1002/jcla.21856
[16]	李红艳, 余先锋, 盛灿, 等. 老年糖尿病伴认知功能下降患者尿AD7c-NTP水平与认知功能的关系[J]. 医学研究生学报, 2022, 35(12): 1283-1287. LI H Y, YU X F, SHENG C, et al. Relationship between urinary AD7c-NTP level and cognitive function in elderly patients with diabetes mellitus and cognitive decline[J]. Journal of Medical Postgraduates, 2002, 35(12): 1283-1287.
[17]	朱贺, 殷实. 认知障碍与抑郁症关系的研究进展[J]. 实用老年医学, 2023, 37(3): 234-237. ZHU H, YIN S. Research progress on the relationship between cognitive impairment and depression[J]. Practical Geriatrics, 2023, 37(3): 234-237.
[18]	罗瑜, 谷悦, 刘海生, 等. 度洛西汀联合高频重复经颅磁刺激治疗难治性抑郁症的对照研究[J]. 临床精神医学杂志, 2020, 30(1): 60-62. LUO Y, GU Y, LIU H S, et al. Comparative study of duloxetine combined with high-frequency repetitive transcranial magnetic stimulation in treatment of refractory depression[J]. Journal of Clinical Psychiatry, 2020, 30(1): 60-62.
[19]	杨荣梅, 胡希文, 王艳涛, 等. 高频重复经颅磁刺激联合度洛西汀在重度抑郁发作急性期的疗效[J]. 临床精神医学杂志, 2019, 29(2): 118-120. YANG R M, HU X W, WANG Y T, et al. Effect of high-frequency repetitive transcranial magnetic stimulation combined with duloxetine on acute stage of major depressive episode[J]. Journal of Clinical Psychiatry, 2019, 29(2): 118-120.
[20]	付冰冰, 周佳, 张玲, 等. 早发与晚发抑郁障碍住院患者用药情况的回顾性分析[J]. 神经疾病与精神卫生, 2021, 21(4): 259-264. FU B B, ZHOU J, ZHANG L, et al. Retrospective analysis of drug use in inpatients with early-onset and late-onset depressive disorder[J]. Journal of Neuroscience and Mental Health, 2021, 21(4): 259-264.
[21]	许洪敏, 傅红梅, 贺娜英, 等. 晚发性抑郁患者随访一年的认知功能变化及静息态fMRI研究[J]. 放射学实践, 2019, 34(2): 130-135. XU H M, FU H M, HE N Y, et al. Study of cognitive function and resting state fMRI in patients with late-onset depression during one-year follow-up[J]. Radiologic Practice, 2019, 34(2): 130-135.
[22]	饶冬萍, 刘文滔, 邹灿芳. 针刺治疗缓解期老年抑郁症伴轻度认知障碍临床观察[J]. 光明中医, 2023, 38(10): 1919-1922. RAO D P, LIU W T, ZOU C F. Clinical observation of acupuncture in the treatment of mild cognitive impairment in elderly patients with depression in remission[J]. Guangming Journal of Chinese Medicine, 2023, 38(10): 1919-1922.
[23]	付晓凡, 姚金兰, 钱敏才, 等. 老年抑郁症认知损害及非药物干预研究进展[J]. 护士进修杂志, 2019, 34(10): 901-904. FU X F, YAO J L, QIAN M C, et al. Research progress of cognitive impairment and non-drug intervention in senile depression[J]. Journal of Nurses Training, 2019, 34(10): 901-904.
[24]	邢晓娟, 慕丹, 朱妍霞. 作业疗法对老年抑郁症恢复期伴轻度认知障碍患者的影响[J]. 心理月刊, 2023, 18(14): 106-108. XING X J, MU D, ZHU Y X. The effect of occupational therapy on the elderly patients with mild cognitive impairment during the recovery period of depression[J]. Psychologies Magazine, 2019, 18(14): 106-108.
[25]	韩悦, 杨振华, 韩庆烽, 等. 多病共存患者认知功能的管理现状[J]. 中华全科医学, 2023, 21(8): 1388-1392. doi: 10.16766/j.cnki.issn.1674-4152.003129 HAN Y, YANG Z H, HAN Q F, et al. Management of cognitive function in patients with multiple diseases[J]. Chinese Journal of General practice, 2023, 21(8): 1388-1392. doi: 10.16766/j.cnki.issn.1674-4152.003129
[26]	梁春华, 肖小华, 胡火有. 尿液AD7c-NTP与阿尔茨海默病[J]. 罕少疾病杂志, 2021, 28(4): 109-112. LIANG C H, XIAO X H, HU H Y. Urine AD7c-NTP and Alzheimer's disease[J]. Journal of Rare and Uncommon Disease, 2021, 28(4): 109-112.
[27]	LI Y, KANG M, WANG H, et al. Urinary Alzheimer-associated neuronal thread protein is not elevated in patients with subjective cognitive decline and patients with depressive state[J]. J Alzheimers Dis, 2019, 71(4): 1115-1123.