神经病理性疼痛患者血清BDNF,5-HT水平

目的 研究神经病理性疼痛(NP)患者的血清脑源性神经营养因子(BDNF)和5-羟色胺(5-HT)水平变化及其焦虑、抑郁状况,探索NP可能的生化机制和临床心理特征.方法 在精神专科医院门诊和综合医院神经科门诊收集NP患者(NP组)35例,同期收集健康对照者(对照组)42人,进行血清采集和量表评定,用ELISA法测其血清BDNF和5-HT浓度,采用疼痛视觉模拟评分法(VAS)、Zung抑郁自评量表(SDS)和Zung焦虑自评量表(SAS)评估研究对象的疼痛强度、抑郁和焦虑水平.结果 NP组BDNF血清浓度显著低于对照组,差异有统计学意义(t=2.157,P=0.034),两组5-HT血清浓度的差异无统计学意义(t=-0.315,P=0.754)；对照组BDNF与5-HT血清浓度呈正相关(r=0.461,P=0.004).VAS与5-HT浓度呈负相关(r=-0.326,P=0.021)；NP组SDS、SAS评分均高于对照组(t=2.058,P=0.039;t=2.568,P=0.011),VAS分与SAS及SDS评分均呈正相关(r=0.502,P=0；r=0.346,P=0.018)；SDS分、SAS分与BDNF、5-HT浓度水平均无相关性.结论 BDNF可能在神经病理性疼痛发生的生化机制中起一定作用；NP患者的焦虑、抑郁症状明显,但主要表现为疼痛感所致的继发性状态,与NP的生化机制无相关性.

The contrast study of serum levels of BDNF and 5 -- HT in neuropathic pain patients

Objective To study the serum levels of brain--derived neurotrophic factor （BDNF） and 5--hydroxytryptamine （5- HT） and clinical psychological symptoms in patients with neuropathic pain （NP）. Methods 35 patients with NP （ NP group） from mental hospitals or General hospitals and 42 health people （contrast group） were recruited. Subjects were assessed by Visual Analogue Scale （VAS）, Self--rating depression scale （SDS） and Self--rating anxiety scale （SAS）. Their serum BDNF and 5--HT were detected using enzyme Linked--Immuno--Sorbent Assay （ELISA）. Results The ser- um BDNF concentration level in NP group was significantly lower than that in contrast group （t = -- 2. 157,P = 0. 034）. There wasn＇t obvious difference on serum 5--HT level between two groups （t=- 0. 315 ,P = 0. 754）. Significant correlations between serum levels of BDNF and 5-- HT were founded in contrast group （r = 0. 461,P = 0. 004）, and no correlation in NP group （r =-0. 041,P = 0. 814）. There was significant correlations between serum levels of 5--HT level and VAS scores （r =- 0. 326, P = 0. 021）, but no significant correlations between serum levels of BDNF and VAS scores in NP group. The scores of NP group were significantly higher than the contrast group in SDS and SAS （t = 2. 058, P = 0. 039 ; t = 2. 568, P = 0. 011）. Significant correlations were observed between VAS scores and SAS scores or SDS scores in NP group （r= 0. 502,P = 0;r= 0. 346,P = 0. 018）. Conclusions BD- NF probably play a important role in pathological mechanism of NP. The anxiety and depression symp- toms of NP were observed, but their occurrence possibly were unrelated to serum levels of BDNF and 5--HT.