老年抑郁症患者血管紧张素转换酶基因多态性与认知功能关系研究

目的探讨老年抑郁症患者血管紧张素转换酶（ACE）基因第16内含子插Ⅳ缺失（Inser-tion／Deletion，I／D）多态性分布特征和认知功能及其之间的关系。方法采用病例对照研究，病例组为97例符合美国精神障碍诊断统计手册第4版（DiagnosticandStatisticalManualofMentalDisorders，FourthEdi—tion，DSM—IV）抑郁症诊断标准的住院患者，其中男性33例，女性64例，年龄60—78岁，平均年龄（68±5）岁；健康对照组103例，其中男性30例，女性73例，平均年龄（66±6）岁。所有的患者及44例健康对照者完成了汉密尔顿抑郁量表（HAMD）评估及神经心理学测试。用聚合酶链式反应（PCR）法进行ACE基因扩增和I／D多态性分型。结果患者组的神经认知测试成绩除连线测试B成绩外，其余的成绩都显著低于正常对照组（P〈0．001）；相关性分析显示患者组的数字广度测试（顺背）成绩与HAMD总分成负相关（r=-0．213，P=0．040）。患者组和对照组间基因型及等位基因频率分布差异无统计学意义（x2=1．745，P=0．418；X2=0．700，P=0．403）；进一步按性别分层分布差异无统计学意义（P〉0．05）。患者组各基因型问在认知功能方面的差异无统计学意义（P〉0．05）。结论老年抑郁症患者存在广泛的认知功能受损，抑郁严重程度与工作记忆成绩密切相关，ACE基因I／D多态性与老年抑郁症的发病及认知功能无显著关联性。

The relationships of the angiotensin converting enzyme gene polymorphism and cognitive function in senile depressive patients

Objective To explore the relationships between angiotensin converting enzyme （ACE） gene polymorphism of insertion/deletion（L/D） and cognition function in senile depressive patients in Chinese Han pop- ulation. Methods 97 patients with major depression were recruited according to the Diagnostic and Statistical Manual of Mental Disorders ,Fourth Edition criteria, and 103 healthy persons were used as controls. The Hamilton Depression Scale （HAMD） and neuropsychologieal tests were used to assess depressive severity and cognitive function in all patients and 44 healthy controls, respectively. The intron 16 L/D polymorphism of ACE gene was de- tected by polymerase chain reaction （PCR）. Results The performances of neuropsychological tests in case group except TMT B were significantly poorer than those in control group （P〈 0.001 ）. Correlation analysis indicated that the total scores of HAMD were negatively associated with Digit Span Test forward score in senile depressive patients （ r = -0. 213, P = 0.040）. There were no significant differences between case and controls on genotype and allele frequencies of ACE gene（ X2 = 1. 745, P= 0. 418 ; X2 = 0.700, P= 0. 403）. And there were no significance in dif- ferent sex, respectively （P 〉 0.05 ）. Furthermore, no significant differences of neuropsychologieal test performances were found between ACE genotypes of senile depressive patients （P 〉 0.05 ）. Conclusion Senile depressive pa- tients have extensive cognitive impairments in the acute phase of illness, and working memory performance is corre- lated with depression severity. ACE gene L/D polymorphism may not significantly associate with cognitive function in senile patients.