| Objective:Investigate the serum vitamin B12 and folic acid levels in patients with depression and explore the differences between them and healthy people,and further explore the clinical value of vitamin B12 and folic acid in depression.Methods:(1)A random sampling method was used to select 200 depressive patients aged18-60 years who were hospitalized in the psychosomatic department of the First Affiliated Hospital of Nanchang University from May 2016 to May 2017 as the depression group,and 200 healthy family members aged 18-60 years who were Accompanying hospitalized during the same period as healthy controls.Testing Serum Vitamin B12 and folic acid Concentration in Patients with Depression group and Healthy Control group by electrochemiluminescence immunoassay,To compare serum vitamin B12 and folic acid levels between the depression group and the healthy control group.(2)A random sampling method was used to select 165 patients with ICD-10 diagnosed as mild-moderate depression hospitalized in the Department of Psychiatry,First Affiliated Hospital of Nanchang University from May 2016 to December 2017.Using random number tables to randomize subjects into three treatment groups:A group:55 cases of sertraline hydrochloride combined with vitamin B12 treatment group;B group:55 cases of sertraline hydrochloride combined with folic acid treatment group;C group:55 cases of sertraline hydrochloride treatment alone.The HAMD and TESS scores were improved before treatment and on the 1st,2nd,4th,6th,and 8th weekends after treatment.Complete general hematological examinations,electrocardiograms,and other related examinations before treatment and at the 4th and 8th weekends after treatment,Serum vitamin B12 concentrations in group A,serum folate concentrations in group B,serum vitamin B12 and serum folate concentrations in group C were measured on the 4th weekend and 8th weekend aftertreatment.Analysis of therapeutic efficacy,side effects,serum vitamin B12 and folic acid levels in the three treatment groups.Results:(1)47 patients in the depression group had vitamin B12 deficiency(23.5%)and41 had folate deficiency(20.5%),In the healthy control group,there were 7 cases of vitamin B12 deficiency(3.5%)and 11 cases of folic acid deficiency(5.5%).The concentrations of serum vitamin B12 and folic acid in the depression group were(540.17±262.54)pg/m L and(7.13±4.25)ng/mL,respectively.The concentrations of serum vitamin B12 and folic acid in the healthy control group were(606.59±233.14)pg/mL and(8.18±4.27)ng/mL,respectively.the serum vitamin B12 and folic acid levels in depression group were lower than those in healthy control group(P=0.008,P=0.014).(2)There was no significant difference in HAMD scores between group A and group C,group B and group C before treatment,and on the 6th weekend and 8th weekend after treatment(P>0.05).However,HAMD scores were significantly lower in group A than in group C and significantly lower in group B than in group C at the first weekend,second weekend,and fourth weekend after treatment(P<0.05).There was no significant difference between HAMD scores before and after treatment in groups A and B.(P>0.05).(3)After 8 weeks of treatment,there was no significant difference in treatment effect between A,B and C groups(p=0.467).(4)There was no significant difference in each TESS score between group A and group C,group B and group C,group A and group B after treatment(P>0.05).The side effects of the three treatment groups were mild and patients could tolerate.The side effects were mostly dry mouth,nausea,loss of appetite,constipation,blurred vision,etc.There were no obvious abnormalities in laboratory tests and electrocardiogram examinations.(5)Serum vitamin B12 concentration in group A was significantly higher than that in group C at the 4th and 8th week after treatment(P<0.05).Serum folic acid concentration in group B was significantly higher than that in group C at the 4th weekend and 8th week after treatment(P<0.05).The serum vitamin B12 concentration in group A was significantly higher than the serum vitamin B12 concentration at the end of the fourth week after treatment(P<0.05).Serum folic acidconcentration in group B at the 8th week after treatment was significantly higher than that at the 4th weekend(P<0.05).In group C,serum vitamin B12 and folic acid concentrations at the 8th week after treatment were significantly higher than serum vitamin B12 and folic acid concentrations at the 4th weekend(P<0.05).Conclusion:Serum vitamin B12 and folic acid levels were lower in depressed patients than in normal subjects.The role of vitamin B12 and folic acid in the adjuvant treatment of depression can shorten the onset time of antidepressants,and antidepressants combined with vitamin B12 or folic acid can not only be effective but also safe in the treatment of depression. |
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