广西医学

目的探讨血清高敏C反应蛋白（hs⁃CRP）、维生素D结合蛋白（VDBP）水平与青少年抑郁症患者疾病严重程度及抗抑郁治疗效果的关系。方法选择210例青少年抑郁症患者（抑郁组）和116例健康志愿者（对照组），根据汉密尔顿抑郁量表（HAMD）评分将抑郁组再分为轻度抑郁组（63例）、中度抑郁组（85例）和重度抑郁组（62例）。给予抑郁组患者心理干预和抗抑郁药物治疗。比较抑郁组（治疗前）与对照组，不同抑郁程度患者（治疗前）的血清hs⁃CRP、VDBP水平，采用Pearson相关系数分析抑郁组治疗前血清hs⁃CRP、VDBP水平与治疗前HAMD评分的相关性，采用多因素Logistic回归模型分析抗抑郁治疗效果的影响因素，采用受试者工作特征曲线评估血清hs⁃CRP、VDBP水平单独及联合预测抗抑郁治疗效果的价值。结果抑郁组的血清hs⁃CRP、VDBP水平高于对照组（P<0.05）。血清hs⁃CRP、VDBP水平由高至低依次为重度抑郁组>中度抑郁组>轻度抑郁组（P<0.05）。青少年抑郁症患者的血清hs⁃CRP、VDBP水平与治疗前HAMD评分呈正相关（P<0.05）。高血清hs⁃CRP水平、高血清VDBP水平是青少年抑郁症患者抗抑郁治疗无效的危险因素（P<0.05）。血清hs⁃CRP水平、血清VDBP水平单独及联合预测青少年抑郁症患者抗抑郁治疗效果的曲线下面积分别为0.791、0.811、0.894，联合预测的曲线下面积大于单独预测的曲线下面积（P<0.05）。结论青少年抑郁症患者的血清hs⁃CRP、VDBP水平增高，且高水平的hs⁃CRP、VDBP与抑郁程度加重及抗抑郁治疗反应性差有关。相较于单独预测，上述两项指标联合预测青少年抑郁症患者抗抑郁治疗效果的效能更优。

Objective To investigate the relation of serum high sensitivity C⁃reactive protein (hs⁃CRP) and vitamin D binding protein (VDBP) levels with disease severity and antidepressant⁃therapy effect in adolescents with depression. Methods A total of 210 adolescents with depression (the depression group), and 116 healthy volunteers (the control group) were selected. According to the Hamilton Depression Scale (HAMD) score, the depression group was further divided into mild depression group (63 cases), moderate depression group (85 cases), or severe depression group (62 cases). Psychological intervention and antidepressant medication were given to the depression group. The serum hs⁃CRP and VDBP levels were compared between the depression group (before treatment) and the control group, and between patients with different depression degrees (before treatment). The correlation of serum hs⁃CRP and VDBP levels of the depression group before treatment with HAMD score before treatment was analyzed by employing the Pearson correlation coefficient. The influencing factors for antidepressant⁃therapy effect were analyzed by using the multivariate Logistic regression model. The receiver operating characteristic curve was employed to evaluate the value of serum hs⁃CRP and VDBP levels for alone and jointly predicting the value of antidepressant⁃therapy effect. Results The levels of serum hs⁃CRP and VDBP in the depression group were higher than those in the control group (P<0.05). The levels of serum hs⁃CRP and VDBP from high to low were as follows: the severe depression group, the moderate depression group, and the mild depression group (P<0.05). Serum hs⁃CRP and VDBP levels in adolescents with depression positively correlated with HAMD score before treatment (P<0.05). High serum hs⁃CRP and VDBP levels were risk factors for the failure of antidepressant treatment in adolescents with depression (P<0.05). Areas under the curve of serum hs⁃CRP and VDBP levels for alone and jointly predicting antidepressant⁃therapy effect in adolescents with depression were 0.791, 0.811, and 0.894, respectively, and area under the curve of combined prediction was larger than that of single prediction (P<0.05). Conclusion The levels of serum hs⁃CRP and VDBP are increased in adolescents with depression, and they are related to increased depression and poor response to antidepressant treatment. The combination of the aforementioned two indices for predicting antidepressant⁃therapy effect in adolescents with depression is superior to the single prediction.