郑天生 董周浒 张赢斌 林光耀 叶敏捷

[摘要] 目的 探討血清胆固醇含量对抑郁障碍患者认知功能的影响。 方法 本研究纳入2015年7月～2017年2月期间在我院住院的66例抑郁障碍患者，分为较高胆固醇组和较低胆固醇组，均进行重复性成套神经心理状态测验（RBANS）和威斯康辛卡片测验（WCST）。 结果 ①较高胆固醇组的RBANS总分、注意力、言语功能、视觉广度、即刻记忆和延时记忆各因子得分高于较低胆固醇组，差异有统计学意义（P<0.05）。②较高胆固醇组在WCST中的选择错误率、完成第一个分类所需应答数、持续性错误数、持续性错误率、非持续性错误数和非持续性错误率的得分均低于较低胆固醇组，差异有统计学意义（P<0.05）;在完成分类数、总应答数、正确应答数、概念化水平百分数均显著高于较低胆固醇组，差异有统计学意义（P<0.05）。 结论 抑郁障碍患者中较高胆固醇组的认知功能优于较低胆固醇组，胆固醇对抑郁障碍患者的认知功能有保护作用。

[关键词] 抑郁障碍;总胆固醇;重复性成套神经心理状态测验（RBANS）;威斯康辛卡片测验（WCST）

[中图分类号] R749.4          [文献标识码] B          [文章编号] 1673-9701（2020）17-0080-04

Effects of serum cholesterol content on cognitive function in patients with depression disorder

ZHENG Tiansheng1   DONG Zhouhu2   ZHANG Yingbin3   LIN Guangyao1   YE Minjie1

1.Depression Diagnosis and Treatment Center/Sleep Diagnosis and Treatment Center，Kangning Hospital Affiliated to Wenzhou Medical University，Wenzhou   325000，China;2.School of Psychiatry， Wenzhou Medical University，Wenzhou 325035，China;3.Renji College，Wenzhou Medical University，Wenzhou   325035，China

[Abstract] Objective To explore the effect of serum cholesterol content on cognitive function in patients with depression disorder. Methods 66 patients with depressive disorder who were admitted to our hospital from July 2015 to February 2017 were selected as study subjects. They were divided into a higher cholesterol group and a lower cholesterol group， and they were all received repeatable battery for the assessment of neuropsychological status（RBANS） and Wsiconsin card sorting test（WCST）. Results ①The scores of RBANS， attention， speech function， visual breadth， immediate memory and delayed memory of the higher cholesterol group were higher than those of the lower cholesterol group，and the differences were statistically significant（P<0.05）. ②In WCST，the scores of selection error rate， response number required to complete the first classification，persistent error number，persistent error rate， non-persistent error number and non-persistent error rate of the higher cholesterol group were all lower than those of the lower cholesterol group，and the differences were statistically significant（P<0.05）; the number of completed classifications，the total number of responses， the number of correct responses，and the percentage of conceptualization levels were significantly higher than those of the lower cholesterol group，and the differences were statistically significant（P<0.05）. Conclusion In patients with depression disorder， the cognitive function of the higher cholesterol patients is better than that of the lower cholesterol patients，and cholesterol play a protective role in the cognitive function of patients with depression disorder.

[Key words] Depression disorder; Total cholesterol; Repeatable battery for the assessment of neuropsychological status; Wsiconsin card sorting test

抑郁障碍是最常见的精神障碍之一，根据世界卫生组织报告称抑郁障碍已经成为全球第四大疾病负担，也是导致患者功能残疾的主要原因之一[1]。目前对抑郁障碍的认知功能研究发现，无论是首发抑郁障碍患者还是缓解期抑郁障碍患者均存在认知功能障碍[2，3]。胆固醇是血清中的重要组成成分，有研究发现焦虑抑郁患者的胆固醇摄入明显低于正常对照[4]，且低胆固醇水平增加抑郁症自杀风险[5]。周珊珊等[6]发现首发青年抑郁障碍患者的血清总胆固醇（Total cholesterol，TC）的高低与患者认知功能关系密切，较低胆固醇水平组患者的记忆力水平受损比较高胆固醇水平组患者更为严重，尤其在理解和持续错误数方面表现更差。本研究将抑郁障碍患者分为较高胆固醇组和较低胆固醇组，探讨胆固醇对抑郁障碍患者认知功能的影响，为临床医生处理抑郁障碍患者胆固醇升高提供新的视角，现报道如下。……