快感缺失被定义为兴趣或快乐的显着丧失，是难治性抑郁症（TRD）的核心症状之一，通常与不良预后相关。本文主要探讨TRD患者小剂量艾氯胺酮治疗后快感缺乏症状、炎症标志物和皮质醇水平的变化。共有 60 名 TRD 患者参加了艾氯胺酮的临床研究。我们主要分别在艾氯胺酮治疗前和每次治疗后 24 小时内分别使用汉密尔顿抑郁量表 (HAMD) 和斯奈斯-汉密尔顿愉悦量表 (SHAPS) 评估抑郁症状和快感缺乏的严重程度。第一次治疗前和第六次治疗后1小时内采集血样，测定皮质醇、白细胞介素6（IL-6）、白细胞介素4（IL-4）和肿瘤坏死因子-α（TNF-α）的水平。 α）在血浆中。我们发现连续六次输注小剂量艾氯胺酮后，患者的抑郁症状和快感缺乏有所改善。经过六次治疗后，TRD 患者血浆皮质醇、IL-6 和 TNF-α 水平下降，而抗炎细胞因子 IL-4 水平上升。多元线性回归分析显示，基线皮质醇水平与快感缺乏相关，而炎症因子则没有显着相关性。添加艾氯胺酮似乎是治疗 TRD 快感缺失的不错选择。它还对改变 TRD 患者的炎症标志物显示出良好的效果。此外，升高的血浆皮质醇水平可能作为 TRD 患者快感缺失的潜在生物标志物。© 2024。Springer-Verlag GmbH 德国，Springer Nature 旗下公司。

Anhedonia, defined as a significant loss of interest or pleasure, is one of the core symptoms of treatment- resistant depression (TRD) and is often associated with poor prognosis. This article primarily investigates the changes in anhedonia symptoms, inflammatory markers, and cortisol levels in TRD patients after low-dose esketamine treatments. A total of sixty patients with TRD were enrolled in the clinical study of esketamine. We primarily assessed the severity of depressive symptoms and anhedonia using the Hamilton Rating Scale for Depression (HAMD) and the Snaith-Hamilton Pleasure Scal(SHAPS), respectively, before esketamine treatment and within 24 h after each treatment. Blood specimens were collected before the first treatment and within 1 h after the sixth treatment, measuring the levels of cortisol, interleukin-6(IL-6), interleukin-4(IL-4), and tumor necrosis factor-alpha(TNF-α) in plasma. We found that after six consecutive infusions of low-dose esketamine, patients' depressive symptoms and anhedonia showed improvement. After six treatments, plasma levels of cortisol, IL-6, and TNF-α decreased in patients with TRD, while the anti-inflammatory cytokine IL-4 increased. Multiple linear regression analysis revealed that baseline cortisol levels were correlated with anhedonia, while inflammatory factors showed no significant correlation. Add-on esketamine appears to be a good choice for the treament of the anhedonia in TRD. It has also shown promising effects on altering inflammatory markers in patients with TRD. Moreover, elevated plasma cortisol levels may serve as a potential biomarker for anhedonia in patients with TRD.© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.