中国汉族人群双相障碍不同疾病状态下的氧化应激损害

摘要

Objective To explore differences of oxidative stress damage among different phases in patients with bipolar disorder. Methods Fifty - three patients with bipolar I disorder and 59 healthy controls(HC)were recruited in Guangzhou Huiai Hospital. Hamilton Depression Scale - 17 item(HAMD - 17)and Bech - Rafaelsen Mania Rating Scale(BRMS)were used to assess the clinical symptoms. Peripheral blood were collected in the early morning and used to test the contents of superoxide dismutase (SOD),glutathione peroxidase(GPx)and Malonaldehyde(MDA)in all participants. Results ①The contents of MDA(F = 8. 362, P ﹤ 0. 01)and GPx(F = 4. 550,P = 0. 013)in patients were higher than HC. ②Patients were divided into manic group(MA)and depressive group(DP)according to the clinical symptoms. There were significant differences in MDA among the MA,DP and HC (F = 6. 079,P ﹤ 0. 01). MDA in MA and DP were higher than HC,respectively(P ﹤ 0. 01). The differences of GPx were significant among the three groups(F = 3. 355,P = 0. 022). GPx in DP was higher than HC(P = 0. 012). ③Patients were divided into psychotic group(Ps)and non - psychotic group(NPs)according to the psychotic symptoms. There were significant differences in MDA among the Ps,NPs and HC(F = 5. 646,P = 0. 001). MDA in Ps and NPs were higher than HC,respectively(P ﹤ 0. 05 或 0. 01). The differences of GPx were significant among the three groups(F = 4. 356,P ﹤ 0. 01). GPx in Ps was higher than HC(P ﹤ 0. 01). ④There were no significant association between age of episode,counts of inpatient,duration of illness,HAMD and BRMS with SOD, GPx and MDA,respectively(P ﹥ 0. 05). Conclusion There is oxidative stress system disturbance in the episode phrase of patients with bipolar disorder,which may be associates with the clinical characters.%目的：探索双相障碍患者的氧化应激指标水平，特别是不同的疾病状态是否存在差异。方法纳入53例双相障碍 I 型患者和59例正常对照组，患者组躁狂发作34例，抑郁发作19例。收集患者临床资料，采用汉密尔顿抑郁量表17项版（HAMD -17）和贝克-拉范森躁狂量表（BRMS）评定症状严重程度。所有受试者抽取清晨空腹外周静脉血，检测生化指标超氧化物歧化酶（Superoxide dismutase，SOD）、谷胱甘肽过氧化物酶（Glutathione peroxidase，GPx）和丙二醛（Malonaldehyde，MDA）水平。结果控制体质指数（BMI）后，①患者组的 MDA（F =8.362，P ﹤0.01）和 GPx（F =4.550，P =0.013）水平均较正常对照组高。②将患者组分为躁狂发作组和抑郁发作组，MDA 水平三组间总体差异有统计学意义（F =6.079，P ﹤0.01），躁狂发作组和抑郁发作组均较正常对照高（P ﹤0.01）。GPx 活性三组间总体差异有统计学意义（F =3.355，P =0.022），抑郁发作组比正常对照组高（P =0.012）。③将患者组分为有精神病性症状组和无精神病性症状组，MDA 水平三组间总体差异有统计学意义（F =5.646，P =0.001）。有精神病性症状组和无精神病性症状组均比正常对照组高（P ﹤0.05或0.01）。GPx 活性三组间总体差异有统计学意义（F =4.356，P ﹤0.01），有精神病性症状组较正常对照组高（P ﹤0.01）；④未见发病年龄、住院次数、病程、HAMD 和 BRMS 评分分别与 SOD、GPx 活性及 MDA 水平显著相关（P 均﹥0.05）。结论双相障碍患者发作期有氧化应激系统失衡，可能和某些临床特征相关。