难治性抑郁症患者血清脑源性神经营养因子动态分析

目的 通过对难治性抑郁症(TRD)患者不同阶段血清脑源性神经营养因子(BDNF)水平的动态监测,探讨TRD与BDNF的关系.方法 26例TRD患者分别在治疗前、急性治疗期、巩固期、维持期四个阶段进行汉密尔顿抑郁量表(HAMD)评定,用酶联免疫吸附法(ELISA)测定其血清BDNF含量.并于治疗前与非难治性抑郁症(TNRD)患者及正常体检者各30例进行对照.结果 治疗前,TRD组与TNRD组HAMD评分均较正常组显著升高(P＜0.01);血清BDNF水平则较正常组显著降低(P＜0.01),其中TRD组比TNRD组下降更明显(P＜0.01),相关性分析表明血清BDNF水平与HAMD评分呈明显负相关(r=-0.667,P＜0.01);治疗后,TRD巩固期和维持期血清BDNF水平较治疗前和急性治疗期均有明显升高(P＜0.01),同时HAMD评分也较治疗前和急性治疗期减少(P＜0.01),其中维持期减少更为明显(P＜0.01).结论 血清BDNF水平低下可能是TRD的病理机制之一,有效的抗抑郁药物治疗机制之一可能是通过提高BDNF水平而起作用的,BDNF可以作为反映TRD疗效的生物学指标.

Dynamic changes in the levels of serum brain derived neurotrophic factor in patients with refractory depression

Objective To investigate the dynamic changes of the levels of serum brain derived neu- rotrophic factor in patients with refractory depression and to explore the relationship between brain derived neurotrophic factor and refractory depression. Methods 26 patients with refractory depression were assessed with 24--item HAMD at four different stages： before treatment,acute stage, consolidation, maintain remedial period. The serum level of BDNF was detected by ELISA. The control groups were 30 individuals having general physical examination and 30 patients with nonrefractory depression. Results Before treatment, the HAMD score of the refractory depression group and non--refractory depression group were remarkable higher than that in the normal group （P 〈 0.01） ; the levels of serum brain derived neurotrophic factor were significantly lower than normal group （P 〈 0.01）. Correlation analysis： there was a negative correlation between the HAMD score and the levels of serum brain derived neurotrophic factor （r =-0. 667,P 〈 0.01）. The levels of serum BDNF at consolidation and maintain remedial period were remarkable higher than before treatment and acute stage （P 〈 0.01）, and the HAMD score at consolidation and maintain remedial period were remarkable lower than before treatment and acute stage （P 〈0.01）. Conclusions The low level of serum BDNF might play a role in the underlying mechanism of refractory depression,serum BDNF level can act as one of the marker of therapeutic evaluation of refractory depression.