摘要
目的:探讨高血压伴焦虑抑郁症与肾素-血管紧张素-醛固酮系统及皮质醇浓度之间的关系。方法:对本院高血压科随机选择的65名高血压患者进行问卷调查,问卷调查的内容包括焦虑自评量表(SAS)和抑郁自评量表(SDS),同时给予这些患者抽血行卧立位肾素-血管紧张素-醛固酮及皮质醇节律检查。对相关数据采用X2检验、秩和检验及相关性分析。结果:高血压合并焦虑症患者与高血压不合并焦虑患者之间性别、凌晨1∶00皮质醇浓度及立位肾素存在差异,有统计学意义(P<0.05),高血压合并抑郁症患者与高血压不合并抑郁症患者之间凌晨1∶00皮质醇浓度有差异,有统计学意义(P<0.05),相关性分析时,高血压合并焦虑症患者与性别、凌晨1∶00皮质醇浓度存在相关性,高血压合并抑郁症与凌晨1∶00皮质醇浓度浓度存在相关性,有统计学意义(P<0.05)。结论:高血压合并焦虑抑郁症与性别、肾素水平、皮质醇浓度有关,皮质醇浓度越高,高血压合并焦虑抑郁症可能性越大。
Objective: To investigate the relationship between hypertension companion depression or anxiety and renin level and cortisol rhythm. Methods: From our hypertensive department randomly selected 65 hypertensive patients conducted a questionnaire survey, questionnaire included self-rating anxiety scale (SAS) and self-rating depression scale (SDS), at the same time give these patients orthostatic lying blood renin -- angiotensin - aldosterone and cortisol rhythm checks. relevant data using X2 test, rank sum test and correlation analysis. Results: Gender, 1:00 am cortisol concentration and Orthostatic renin have statistical signifiance between hypertension companion anxiety and do not companion anxiety, 1:00 am cortisol concentration have statistical signifiance between hypertension companion depression and do not companion depression. By uesing correlation analysis, hypertension companion anxiety is related with gender,and 1:00 am cortisol concentration; hypertension companion depression is related with 1:00 am cortisol concentration. Conclusion: hypertension companion depression or anxiety is related with gender renin level,cortisol concentration,the higher level of renin and cortisol concentration the greater the likelihood of hypretension companion anxiety and depression.
引文
[1]韦铁民,曾春来,陈礼平等.高血压合并焦虑抑郁[J].高血压杂志,2003,11(6):567-569.
[2] Adamis D ,Ball C. Physical morbidity in elderly psychiatric inpatients:prevalence and possible relations between the major mental disorders and physical illness [J]. Int J Geriatr Psychiatry ,2000 , (15) 3 :248-253.
[3] Jonas BS,Franks P,Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension ?Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study[J]. Arch Fam Med ,1997 ,6 (1):43-49.
[4] Vetere G, Ripaldi L, Ais E,et al. Prevalence of anxiety disorders in patients with essential hypertension. Vertex: Revista Argentina de Psiquiatria. 18(71):20-5, 2007 Jan-Feb.
[5] Wassertheil-Smoller S,Applegate WB ,Berge K,et al. Change in depression as a precursor of cardiovascular events[J]. Arch Inter Med,1996 ,156 (5 ):553-561.
[6] Abramson J ,Berger A , Krumholz HM ,et al. Depression and risk of heart failure among older persons with isolated systolic hypertension[J].Arch Intern Med,2001, 161 (14):1725-1730.
[7]侯显明肾素-血管紧张素-醛固酮系统与高血压的诊断及治疗辽宁医药1978年第6期
[8]瑜,杨钢,万曙霞等.肾素-血管紧张素系统-应激激素反应系统生理学报,1996 ,48(6):521
[9] Hullin RP. Jerram TC. Renin and aldosterone relationships in manic depressive psychosis. British Journal of Psychiatry. 131:575-81, 1977 Dec.
[10]郭友军,汤慈美,梁枫.练气功者应激时体内儿茶酚胺和皮质醇排出量的实验研究.中国行为医学杂志. 1992, 1(1): 20.
[11]刘力生,龚兰生,陈孟勤,等.高血压[M].北京:人民卫生出版社2001,639
[12] DaiH,KaoruN,TakahiroO,etal.Preofrmance of the basa aldosterone to renin ratio and of the renin stimulation test by furese mide and upright pesture in screening for aldosterone一Producing adenoma in low renin hypertensives[J],Clin Endoerinol Metab,2001,86(9):4292-4298
[13] Toufexis, D. Region- and Sex-Specific Modulation of Anxiety Behaviours in the Rat. Journal of Neuroendocrinology.19(6):461-473, June 2007.
[14] Galeeva, A. Yu. 1,2; Tuohimaa, P. 2; Shalyapina, V. G. 1 The Role of Sex Steroids in Forming Anxiety States in Female Mice. Neuroscience & Behavioral Physiology. 33(4):415-420, May 2003.
[15]许庆明?朱洪?翟书清.不同性别抑郁症的临床对照研究.四川?精神卫生,1997,10(3):16
[16]施建安.女性抑郁症的临床特征与治疗对策.国外医学精神病学分册,1996,23(3)176
[17] Seeman MV. Sex and schizophrenica.Can J Psychiatry,1985,30:313
[18]万瑜,杨钢,万曙霞等肾素-血管紧张素系统-应激激素反应系统生理学报,1996 ,48(6):521
[19]廖奕华,刘湘等新老伞兵跳伞后血浆肾素-血管紧张素-醛固酮变化比较,人民军医2005年第48卷第2期总第(543)期
[20] Saab YB. Gard PR. Renin-angiotensin-system gene polymorphisms and depression. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 31(5):1113-8, 2007 Jun 30.
[21] Thailer, S A. Friedman, R. Psychologic differences between high-normal-,and low-renin hypertensives Psychosomatic Medicine.47(3):294-7, 1985 May-Jun.
[22] Albiston AL,Fernando R,Ye S,et al.Alzheimer,s,angiotensinⅣand an aminopeptidase. Biol Pharm Bull,2004,27(6):765-767.
[23] Gard PR,Rusted J M.Angiotensin and Alzheimer’s disease:therapeutic prospects.ExpertRevNeurother,2004,4 (1):87-96.
[24] Gard PR. Angiotensin as a target for the treatment of Alzheimer’s disease,anxiety and depression. Expert Opin Ther Targets,2004,8(1) :7-14.19
[25] Hullin RP. Jerram TC. Renin and aldosterone relationships in manic depressive psychosis. British Journal of Psychiatry. 131:575-81, 1977 Dec.
[26] Emanuele E. Geroldi D. Increased plasma aldosterone in patients with clinical depression. Archives of Medical Research. 36(5):544-8, 2005 Sep-Oct. Abbreviated Source?
[27] Januszewicz W, Sznajderman M an, Wocial D·The effect of men-tal stress on catecholamines, their metabolites and plasma rennin activity in patients with essential hypertension and in health sub-jects·Clin Sci Lond·1979, 57 Suppl: 129s-231s·
[28] JECKINST, MENDELSOHN FA, CHAISY, eta.l Angiotensin-converting enzyme modulates dopamine turnover in the striatum[J]. JNeurochem, 1997, 68(30): 1 304-1 311.
[29] KRAMERM S, CUTLERN, FEIGHNER J, eta.l Distinctmech-anism for anti depressant activity by block ade of central substance P receptors[J]. Science, 1998, 281(5383): 1 640-1 645.
[30] ZUBENKO G S, NIXONR A. Mood-elevating effect of captopril in depressed patients[J]. Am JPsychiatry, 1984, 141(1): 110-111.
[31] [31]OKUYAMA S, SAKAGAWA T, SUGIYAMA F, eta.l Reduction of depressive-like behavior inmice lacking angiotensinogen[J].NeurosciLet,t 1999, 261(3): 167-170.
[32] Mulatero P, PanarelliM, Schiavone D,et al. Impaired cortisol binging to glucocorticoid receptors in hypertensitive patients. Hypertension 1997, 30: 1274.
[33]郭友军,汤慈美,梁枫.练气功者应激时体内儿茶酚胺和皮质醇排出量的实验研究.中国行为医学杂志. 1992, 1(1): 20.
[34]梅仁彪.高血压矿工血浆皮质醇表达水平的研究.安徽理工大学学报(自然科学版). 2006, 26(2): 79.
[35] Bhagwagar, Zubin M.D., M.R.C.Psych. Increase in Concentration of Waking Salivary Cortisol in Recovered Patients With Depression. American Journal of Psychiatry. 160(10):1890-1891, October 2003.
[36] Mathew SJ,Coplan JD,Goetz RR,et al.Differentiating depressed adolescent 24 h cortisol secretion in light of their adult clinical out-come. Neuropsychopharmacology, 2003,28(7):1336-1343.
[37] Alexandros NV,Edward OB,Hung ML,et al.Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pitu-itary-adrenal axis:clinical implications. JClin Endocrinol Metab, 2001,86(8):3787-3794.
[38]陈珏,肖泽萍,林治光,等.抑郁症的生化病理机制探讨.临床精神医学杂志,2002,12(4):193-195.
[39]崔青,侯钢,孙静,等.抑郁症晨重夕轻特征与生物学的关系.临床精神医学杂志,2006,16(5):266-268.
[40] 10 Krishnan KR,Godde KM,Kim YD,et al.Psychoneuroendocrinology and brain imaging in depression.Psychiat Clin North Am,1998,21:465-472.
[41] Lemus CZ.Clinical variable and hypothalamic-pituitary-adrenal function in depression:The importance of mood reactivity.Journal of Affective Disorder, 1987, 12:219-221.
[42] Herbst K,Paykel E.Depression Oxford:Heinemann Professional Publishing Ltd, 1989: 53-601.
[43]朱晓蔓,高扬,周伟君,等.急性缺氧对海马NA含量变化和血浆皮质醇水平的影响[J].生理学报,1996,48(4):385-389.
[1] Jonas B S , Franks P, Ingram D D. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow2up Study[J]. Arch Fam Med ,1997 ,6(1) :43-49
[2] Saab YB. Gard PR. Renin-angiotensin-system gene polymorphisms and depression. Progress in Neuro-Psychopharmacology & Biological Psychiatry.31(5):1113-8, 2007 Jun 30.
[3]韦铁民,曾春来,陈礼平等高血压合并焦虑抑郁高血压杂2003 06-0567-03
[4] Scherrer, Jeffrey F. MA; A Twin Study of Depression Symptoms, Hypertension, and Heart Disease in Middle-Aged Men. Psychosomatic Medicine. 65(4):548-557, July/ August 2003
[5]张保敏,高颖,郭艺芳,高血压与抑郁症,《临床荟萃》2007年9月5日第22卷第17期
[6]万兴松,宋晨霞,龚桂平等.高血压患者心理状况调查J.健康心理学杂志,2000,8 (1):17-19
[7] Adamis D ,Ball C. Physical morbidity in elderly psychiatric inpatients :prevalence and possible relations between the major mental disorders and physical illness[J]. Int J Geriatr Psychiatry ,2000 ,15 (3):248225353
[8] Jonas BS ,Franks P, Ingram DD. Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow up Study[J]. Arch Fam Med ,1997 ,6(1) :43-49.
[9] Karina D,Bruce J,Kim ED, et al. Do depression symptoms predict.early hypertension incidence in young adults in the CARDIA study?Arch Intern Med,2000,160: 1495-1500.
[10]万兴松,宋晨霞,龚桂平,陈大年,高血压患者心理状况调查,健康心理学杂志2000年第8卷第1期
[11]高海清抑郁症与心血管疾病2001年第41卷第10期山东医药
[12]侯显明肾素-血管紧张素-醛固酮系统与高血压的诊断及治疗辽宁医药1978年第6期
[13]钱桐荪肾素-血管紧张素系统的新概念(上)中国中西医结合肾病杂志2007年6月第8卷第6期
[14] Ng KK Vane JR. The conversion of angiotensin I to angiotensin II in vivo. NaunynSchmiedebergs Arch Exp Pathol Pharmakol 1968 ,259: 188-189.
[15]杜昕肾素血管紧张素系统研究的新进展中国心血管病研究杂志2007年4月第5卷第4期?
[16] Albiston AL, Fernando R, Ye S, et al. Alzheimer’s, angiotensinⅣand an aminope- ptidase. Biol Pharm Bull,2004,27(6):765-767.
[17] Gard PR,Rusted J M.Angiotensin and Alzheimer’s disease:therapeutic prospects. ExpertRevNeurother,2004,4 (1):87-96.
[18]Gard PR. Angiotensin as a target for the treatment of Alzheimer’s disease, anxiety and depression. Expert Opin Ther Targets,2004,8(1) :7-14.19
[18]瑜,杨钢,万曙霞等肾素-血管紧张素系统-应激激素反应系统生理学报,1996 ,48(6) :521
[19]廖奕华,刘湘等新老伞兵跳伞后血浆肾素-血管紧张素-醛固酮变化比较,人民军医2005年第48卷第2期总第(543)期
[20] Hullin RP. Jerram TC. Renin and aldosterone relationships in manic depressive psychosis. British Journal of Psychiatry. 131:575-81, 1977 Dec.
[21] Emanuele E. Geroldi D. Increased plasma aldosterone in patients with clinical depression. Archives of Medical Research. 36(5):544-8, 2005 Sep-Oct. Abbreviated Source.
[22] hailer, S A. Friedman, R. Psychologic differences between high-, normal-, and low-renin hypertensives Psychosomatic Medicine.47(3):294-7, 1985 May-Jun.
[23]杜玉凤,彭丹梅,李晓敏,等.原发性高血压伴抑郁症状综合治疗分析[J].临床荟萃,2004,19 (15) :8732874.
[24]才晓君,毕秀萍,赵卓,等.抗抑郁治疗对老年高血压降压疗效的影响[J].中华内科杂志,2006 ,45 (8) :6392641.
[25] Gard, Paul R. Angiotensin as a target for the treatment of Alzheimer's disease, anxiety and depression. Expert Opinion on Therapeutic Targets. 8(1):7-14, 2004 Feb.
[26]吴同果抑郁症与高血压病2001年第41卷第10期山东医药