目的:探究青少年抑郁症患者血清中潜在生物标志物，为抑郁症临床诊断及药物作用机制研究提供依据。方法:筛选符合纳入标准的45例青少年抑郁症患者和47例健康对照(HC组)。抑郁症患者使用舍曲林(100 mg/d)治疗4周，治疗前作为DN-MDD组，治疗后作为DT-MDD组。治疗前后样本采用汉密尔顿抑郁评定量表(HAMD)对两组疗效进行评估。采集HC组，DN-MDD组，DT-MDD组血清进行UPLC-MS/MS测试，采用SPSS 21.0，XCMS和Metabo Analys＋3.0分析血清中内源性代谢产物的变化及其规律，并通过GraphPad 8.0进行ROC分析进一步探讨临床诊断的可靠性和可行性。结果:舍曲林治疗4周后，青少年抑郁症患者HAMD评分降低[治疗前(19.71±1.72)分，治疗后(15.36±1.91)分]，治疗有效率达到51%，差异有统计学意义(n P0.9，天冬氨酸、蔗糖、肌酸、丙酮酸、腺苷AUC>0.7，提示这7种代谢化合物具有不同程度的诊断能力。n 结论:青少年抑郁症患者体内存在着代谢异常，抗抑郁药物舍曲林有助于维持人体内物质代谢的平衡，临床疗效尚佳，可作为青少年抑郁症治疗的方法之一。本研究结果都可以为将来的青少年抑郁症基础研究、临床诊断和药物治疗提供新的思路。“,”Objective:To detect the potential biomarkers in the serum of adolescents with depressive disorder and provide the basis for clinical diagnosis of depression.Methods:A total of 45 adolescents with depression who met the inclusion criteria and 47 healthy controls (HC group) were screened.Patients with depression were treated with sertraline (100 mg/d) for 4 weeks.The patients before sertraline treatment were called DN-MDD group and then were called DT-MDD group after sertraline treatmant.Hamilton Depression Scale (HAMD) was used to evaluate the efficacy of the two groups before and after treatment.The serum was collected for UPLC-MS/MS to determine the changes in profiles of endogenous metabolites.And the software of SPSS 21.0, XCMS and Analyst 3.0 were used to analyze the data.The reliability and feasibility of clinical diagnosis were further analyzed by ROC via GraphPad 8.0.Results:After 4 weeks of sertraline treatment, the patients' HAMD score decreased (before: 19.71±1.72, after: 15.36±1.91) and the effective rate reached 51% (n P0.9, and the AUC of aspartic acid, sucrose, creatine, pyruvate and adenosine were >0.7, suggesting that these 7 metabolites had different degrees of diagnostic ability.n Conclusion:There are different metabolic profiles between adolescents with or without depression, and the antidepressant sertraline is helpful to maintain the level of substance metabolism which can be used as one of the treatment methods for adolescent depression.Our research may support the new strategy for clinical diagnosis and treatment of adolescent depression.