结核病与抑郁症共病的研究进展

doi:10.19982/j.issn.1000-6621.20230381

摘要/Abstract

摘要：

结核病与抑郁症均为当今社会重要的公共卫生问题,二者关系复杂且相互影响。笔者旨在总结近年来关于结核病与抑郁症共病的患病率、危险因素、相互作用机制,并探讨结核病与抑郁症共病的诊断与治疗方式。通过深入了解结核病与抑郁症共病的研究进展,为临床实践提供指导,为未来的研究提供方向。

关键词: 结核, 抑郁症, 共病现象, 研究

Abstract:

Tuberculosis and depression are both global public health concerns. There is a complex interplay between tuberculosis and depression. This review focuses on the literature on prevalence, risk factors, and mechanisms of interaction between these two diseases. We also summarize the progress on the diagnostic and therapeutic strategies for patients with both tuberculosis and depression. By reviewing the research progression in these comorbidities, we aim to extend our understanding on their underlying interaction, which is of great importance for formulating effective strategies on clinical management of these patients, and pointing out the avenues of future research.

Key words: Tuberculosis, Depressive disorder, Comorbidity, Research

中图分类号:

R52
R749

孙青峰, 李浩然, 逄宇, 高孟秋. 结核病与抑郁症共病的研究进展[J]. 中国防痨杂志, 2024, 46(1): 106-111. doi: 10.19982/j.issn.1000-6621.20230381

Sun Qingfeng, Li Haoran, Pang Yu, Gao Mengqiu. Co-morbidity research progress of tuberculosis and depression[J]. Chinese Journal of Antituberculosis, 2024, 46(1): 106-111. doi: 10.19982/j.issn.1000-6621.20230381

图/表 2

表1

表2

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量表名称	英文全称	英文缩写	适用人群	评定方式	主要用途
汉密尔顿抑郁量表	Hamilton depression scale	HAMD	抑郁症患者	他评	评估抑郁症状严重程度及抗抑郁药疗效
蒙哥马利-艾斯伯格抑郁量表	Montgomery-Asberg depression rating scale	MADRS	抑郁症患者	他评	评估抑郁症状严重程度及抗抑郁药疗效
医院焦虑抑郁量表	hospital anxiety and depression scale	HADS	医院躯体疾病患者	自评	筛查
抑郁自评量表	self-rating depression scale	SDS	普通人群	自评	筛查及评估抑郁症状严重程度
贝克抑郁量表	Beck depression inventory	BDI	普通人群	自评	筛查及评估抑郁症状严重程度
九项抑郁症状自评量表	patient health questionnaire-9	PHQ-9	普通人群	自评	筛查及评估抑郁症状严重程度
流调中心用抑郁量表	center for epidemiologic studies depression scale	CES-D	普通人群	自评	流行病学研究
老年抑郁量表	geriatric depression scale	GDS	老年人	自评	筛查
爱丁堡产后抑郁量表	Edinburgh postnatal depression scale	EPDS	产妇	自评	筛查
儿童抑郁量表	children’s depression inventory	CDI	7~17岁儿童	自评	筛查

抗结核药物	抗抑郁药物	相互作用
异烟肼	帕罗西汀	帕罗西汀由CYP2D6代谢,CYP2D6受异烟肼的影响最小,潜在的药物相互作用并不显著^[52-53]
异烟肼	舍曲林	可提高巨噬细胞中异烟肼的杀菌活性,但更多人体试验证据或作用机制尚不明确^[48]
异烟肼	西酞普兰	西酞普兰主要由CYP2C19和CYP3A4代谢,这两种酶会受到异烟肼的抑制^[52]
异烟肼	氟伏沙明	氟伏沙明抑制CYP1A2和CYP2C19,可能还有CYP3A3/4,以上均被异烟肼抑制^[52]
利福平	去甲替林	利福平是许多CYP450酶的有效诱导剂,与去甲胎蛋白相互作用,会降低其血药浓度^[25]
利福平	舍曲林	一份舍曲林和利福平联合用药的病例报告显示,由于利福平诱导CYP450系统而引起舍曲林血药浓度降低,最终导致治疗失败^[50]
利福平	安非他酮	利福平对CYP2B6的诱导作用可能会导致安非他酮代谢增加,但还需要进一步的研究来支持这一观点^[51]
利奈唑胺	选择性5-羟色胺再摄取抑制剂	利奈唑胺是恶唑烷酮类抗生素,也是一种单胺氧化酶抑制剂,与西酞普兰、艾司西酞普兰、舍曲林、氟西汀、帕罗西汀、文拉法辛和度洛西汀等选择性血清素再摄取抑制剂联合使用时可能导致血清素综合征^[25]