双相障碍抑郁发作患者血清脑源性神经营养因子水平变化及相关因素分析

发布时间：2018-10-08 15:53

【摘要】：目的：探讨双相障碍抑郁发作患者血清脑源性神经营养因子（BDNF）水平与发作状态和临床疗效的关系。方法：采用横断面病例对照及前瞻性自身对照设计。对双相障碍抑郁发作组患者（n=30）给予治疗[包括情绪稳定剂、非典型抗精神病药、抗抑郁药及改良电抽搐治疗（MECT）]，并随访治疗4周；采用酶联免疫吸附法（ELISA）测定双相障碍抑郁发作组患者治疗前和治疗第4周末和正常对照组（n=30）的血清BDNF水平，并对双相障碍抑郁发作组患者于治疗前及治疗第1、2、4周末采用汉密尔顿抑郁量表（HAMD）和临床总体印象量表（CGI）评定症状程度。结果：双相障碍抑郁发作组治疗前血清BDNF水平[(18.65±6.13)ng/ml]显著低于正常对照组[(24.87±6.08) ng/ml](t=3.941，P=0.000)，并与治疗前HAMD总分(r=-0.413，P=0.023)及CGI分值(r=-0.404,P=0.027)显著呈负性相关，但是与患者的年龄（r=-0.284，P=0.129）、起病年龄（r=-0.226，P=0.23）、总病程（r=-0.216，P=0.252）、发病次数（r=-0.261，P=0.163）无明显的相关性；治疗第4周末患者血清BDNF水平[(22.56±6.56)ng/ml]显著高于治疗前(t=-4.089，P=0.000)，与正常对照组的差异均无统计学意义(P0.05)，并与治疗后HAMD总分（r=-0.619，P=0.000）及CGI分值(r=-0.589,P=0.001)显著性负相关；治疗4周末血清BDNF增加率与HAMD减分率显著性正相关（r=0.372，P=0.043）。结论：血清BDNF水平低下与双相障碍抑郁发作密切相关，，可能是双相障碍抑郁发作的生物学指标甚至是状态指标；血清BDNF水平升高可能为双相障碍抑郁发作临床疗效的参考指标之一。
[Abstract]:Objective: to investigate the relationship between the serum level of brain-derived neurotrophic factor (BDNF), seizure state and clinical efficacy in patients with bipolar disorder. Methods: cross-sectional case-control and prospective self-control design were used. Patients with bipolar disorder depression attack group (nf30) were treated [including mood stabilizers, atypical antipsychotics, antidepressants and modified electric convulsions (MECT)] and were followed up for 4 weeks. The serum BDNF levels of patients with bipolar disorder were measured by enzyme linked immunosorbent assay (ELISA) before treatment, at the end of the fourth week of treatment and in the normal control group. The patients with bipolar disorder were evaluated with Hamilton Depression scale (HAMD) and Clinical General impression scale (CGI) before treatment and at the end of the first week of treatment. Results: before treatment, the serum BDNF level in the bipolar disorder group [(18.65 卤6.13) ng/ml] was significantly lower than that in the normal control group [(24.87 卤6.08) ng/ml] (t = 3.941), and was negatively correlated with the total HAMD score (r-0.413) and the CGI score (r -0.404 P _ (0.027) before treatment. However, there was no significant correlation between the patients' age (r = 0.284), onset age (r = 0.226P = 0.23), total course of disease (r = 0.216P = 0.252) and the frequency of onset (r = 0.261 / P ~ (0.163), but there was no significant correlation between the patients' age (r = 0.129), onset age (n = 0.23), total course of disease (r = 0.216P = 0.252). The serum BDNF level [(22.56 卤6.56) ng/ml] was significantly higher in the patients at the end of the 4th week than that before the treatment (t = -4.089), but there was no significant difference between the patients and the control group (P0.05). There was also a negative correlation between the level of serum BDNF and the total HAMD score (r-0.619) and the CGI score (r-0.589P0. 001). There was a significant positive correlation between the increase of serum BDNF and the decrease rate of HAMD at the end of 4 weeks (r = 0.372, P = 0.043). Conclusion: the low level of serum BDNF is closely related to bipolar disorder depression attack, which may be a biological index or even state index of bipolar disorder depression attack. The increase of serum BDNF level may be one of the reference indexes for the clinical efficacy of bipolar disorder depression.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.4

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