中老年抑郁症患者执行功能障碍及其与血清脑源性神经营养因子的关系

目的探讨中老年抑郁症患者执行功能及其与血清脑源性神经营养因子(BDNF)的关系,为了解中老年抑郁症患者执行功能及生化指标的变化提供理论基础。方法选取2014年6月-2015年1月在贵州医科大学附属医院心理科住院的、符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)抑郁症诊断标准的中老年住院患者78例(抑郁组),并于同期选取贵州医科大学附属医院职工、心理科患者家属80例(对照组),根据抑郁自评量表(SDS)评分将抑郁组分为轻中度抑郁组和重度抑郁组。采用执行功能行为评定量表成人版自评问卷(BRIEF-A)评定抑郁组和正常对照组的执行功能,包括行为管理指数(BRI)和元认知指数(MI)。采用生物素双抗体夹心酶联免疫吸附法(ELISA)测定BDNF水平。结果抑郁组BRIEF-A总评分、BRI、MI及各因子评分均高于正常对照组(P均0.01);重度抑郁组的抑制、转移、工作记忆因子评分与轻中度抑郁组差异无统计学意义(P均0.05),而BRIEF-A总评分及其他因子评分均高于轻中度抑郁组(P均0.05)。中老年抑郁组BDNF水平低于正常对照组,重度抑郁组BDNF水平低于轻中度抑郁组(P均0.05)。执行功能总评分及各因子评分与BDNF水平的相关均无统计学意义(P均0.05)。结论与正常中老年人相比,中老年抑郁症患者执行功能明显受损,中老年抑郁组患者BDNF水平较低,且随抑郁程度加重而下降。抑郁症患者的执行功能和BDNF水平无明显相关性。

Study of correlation between disorder of executive function and brain derived neurotrophic factor in elderly patients with depression

Objective To explore the executive function of elderly patients with depression and the correlation between disorder of executive function and plasma brain - derived neurotrophic factor(BDNF)in these patients,providing basic theory for further understanding the changes of the cognitive function and the biochemical indexes in elderly patients with depression. Methods 78 patients with depression meeting the diagnose criteria of Diagnostic and Statistical Manual of Mental Disorders(DSM - IV)from the Affiliated Hospital of Guizhou Medical University and 80 normal controls were selected. And then according to the SDS scores,the patients were divided into mild - to - moderate depression group and major depression group. The executive function was assessed by the Behavior Rating Inventory of Executive Function - Adult Version(BRIEF - A),including Behavioral Regulation Index(BRI)and Metacognition Index(MI). Enzyme - linked immunosorbent assay(ELISA)was used to measure the level of BDNF. Results The executive function score and its each factor score in depression group were significantly higher than normal control group(P < 0. 01). The inhibition,transfer,working memory factor score in major depression group had no significant difference with mild - to - moderate depression group(P > 0. 05),while the executive function aggregate score and the other factor scores in major depression group were much higher than mild - to - moderate depression group(P < 0. 05). The level of BDNF in depression group was much lower than the normal control group(P < 0. 05). The level of BDNF in major depression group is much lower than mild - to - moderate depression group(P < 0. 05). The global executive composite and its other functions has no correlation with the level of BDNF(P > 0. 05). Conclusion Compared with normal elderly people,the executive function of elderly patients with depression is obviously impaired. The level of BDNF in elderly patients with depression is much lower,which is decreased with ascending depressive level. The executive function of elderly patients with depression has no correlation with the level of BDNF.