抑郁症患者血清脑源性神经生长因子水平与抗抑郁剂治疗早期疗效的关系

摘要

Objective:To explore the relation of serum brain-derived neurotrophic factor(BDNF)level change with early improvement of antidepressant treatment in patients with depression. Method:Sixty-two de-pression patients were treated by escitalopram for 2 weeks. Acording to the point of reduced rate of Hamilton de-pression scale(HAMD)-17≥20% after treatment,the patients were divided into early improvement group and no-early improvement group. The changes of serum BDNF level before and after treatment were compared be-tweet the two groups and 60 normal controls(normal control group). Results:The baseline serum BDNF level of patients[(1113. 10 ± 321. 36)pg/ ml ]was sinificantly lower than the normal controls[(1379. 14 ± 385. 04) pg/ ml](t = 4. 1487,P ﹤ 0. 01). After treatment,the BDNF level[(1232. 86 ± 338. 4)pg/ ml ]was increased significantly than before treatment(t = 2. 0207,P ﹤ 0. 05),but was still significantly lower than the normal con-trol group(t =2.2308,P =0. 0275). In early improvement group(19 cases)the baseline BDNF level[(1205. 22 ± 308. 35)pg/ ml]and the added value ofter the treatment[(155. 76 ± 81. 02)pg/ ml]were significantly higher than those in the no-early improvement group(43 cases)[(1041. 26 ± 292. 18)pg/ ml,(113. 84 ± 62. 08)pg/ml;t = 2. 0032,t = 2. 2275;all P ﹤ 0. 05]. The serum BDNF level in the early improvement group before and af-ter treatment had no significant difference from normal controls(F = 1. 83,P = 0. 1657). Conclusion:Serum BDNF level in depressive patients are significantly lower. But the patients with smaller reduce and bigger rise af-ter treatment will improve earlier.%目的：探讨抑郁症患者治疗前后血清脑源性神经生长因子（BDNF）水平变化及与早期改善的关系。方法：给予62例抑郁症患者（患者组）艾司西酞普兰抗抑郁治疗2周；以治疗后汉密尔顿抑郁量表（HAMD）-17减分率≥20%为界将患者分为早期改善组及非早期改善组；比较两组患者治疗前后血清 BDNF 水平变化及其与正常对照组（60人）的差异。结果：治疗前患者组血清 BDNF 水平[（1113.10±321.36）pg/ ml]明显低于正常对照组[（1379.14±385.04）pg/ ml]（t ＝4.1487，P ﹤0.01）；治疗2周末[（1232.86±338.4）pg/ ml]较治疗前显著提高（t ＝2.0207，P ＝0.0455），但是仍然低于正常对照组（t ＝2.2308，P ＝0.0275）。早期改善组（19例）血清 BDNF 水平治疗前[（1205.22±308.35）pg/ ml]及治疗2周末 BDNF 增加值[（155.76±81.02）pg/ ml]明显高于非早期改善组（43例）[（1041.26±292.18）pg/ ml，（113.84±62.08）pg/ ml；t ＝2.0032，t ＝2.2275；P 均﹤0.05]；早期改善组治疗前、后血清BDNF 水平与正常对照差异无统计学意义（F ＝1.83，P ＝0.1657）。结论：抑郁症患者血清 BDNF 水平显著降低，但降低幅度较小及治疗后提升幅度较大的患者可获得早期改善。