【摘要】：目的： 探討雙相障礙抑郁發(fā)作患者血清腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）水平與發(fā)作狀態(tài)和臨床療效的關(guān)系。 方法： 采用橫斷面病例對(duì)照及前瞻性自身對(duì)照設(shè)計(jì)。對(duì)雙相障礙抑郁發(fā)作組患者（n=30）給予治療[包括情緒穩(wěn)定劑、非典型抗精神病藥、抗抑郁藥及改良電抽搐治療（MECT）]，并隨訪治療4周；采用酶聯(lián)免疫吸附法（ELISA）測(cè)定雙相障礙抑郁發(fā)作組患者治療前和治療第4周末和正常對(duì)照組（n=30）的血清BDNF水平，并對(duì)雙相障礙抑郁發(fā)作組患者于治療前及治療第1、2、4周末采用漢密爾頓抑郁量表（HAMD）和臨床總體印象量表（CGI）評(píng)定癥狀程度。 結(jié)果： 雙相障礙抑郁發(fā)作組治療前血清BDNF水平[(18.65±6.13)ng/ml]顯著低于正常對(duì)照組[(24.87±6.08) ng/ml](t=3.941，P=0.000)，并與治療前HAMD總分(r=-0.413，P=0.023)及CGI分值(r=-0.404,P=0.027)顯著呈負(fù)性相關(guān)，但是與患者的年齡（r=-0.284，P=0.129）、起病年齡（r=-0.226，P=0.23）、總病程（r=-0.216，P=0.252）、發(fā)病次數(shù)（r=-0.261，P=0.163）無(wú)明顯的相關(guān)性；治療第4周末患者血清BDNF水平[(22.56±6.56)ng/ml]顯著高于治療前(t=-4.089，P=0.000)，與正常對(duì)照組的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)，并與治療后HAMD總分（r=-0.619，P=0.000）及CGI分值(r=-0.589,P=0.001)顯著性負(fù)相關(guān)；治療4周末血清BDNF增加率與HAMD減分率顯著性正相關(guān)（r=0.372，P=0.043）。 結(jié)論： 血清BDNF水平低下與雙相障礙抑郁發(fā)作密切相關(guān)，，可能是雙相障礙抑郁發(fā)作的生物學(xué)指標(biāo)甚至是狀態(tài)指標(biāo)；血清BDNF水平升高可能為雙相障礙抑郁發(fā)作臨床療效的參考指標(biāo)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 鹵6.13) ng/ml] was significantly lower than that in the normal control group [(24.87 鹵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 鹵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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R749.4

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本文編號(hào)：2257350