首发未用药抑郁症患者血浆氨基酸检测分析及其临床意义

目的检测首发未用药抑郁症患者血浆氨基酸浓度并分析其与健康对照者之间的差异以及可能的临床价值。方法使用同位素内标结合串联质谱鉴定的方法测定26例首发未用药抑郁症患者和25例健康对照者血浆氨基酸浓度,同时使用17项汉密尔顿抑郁量表(Hamilton rating scale-17 for depression,HAMD-17)评定患者病情严重程度并进行统计分析。结果与健康对照组相比,抑郁症组中9种氨基酸(色氨酸、苯丙氨酸、赖氨酸、甲硫氨酸、γ-氨基丁酸、α-氨基己二酸、谷氨酰胺、乙醇胺和亮氨酸)存在异常改变(P<0.05);抑郁症组中天冬氨酸和β-氨基异丁酸浓度与汉密尔顿抑郁量表得分呈显著的负性相关(P值分别为0.045、0.006,r值分别为-0.397、-0.521);回归分析提示色氨酸、半胱氨酸和谷氨酰胺组成的预测模型对抑郁组和健康对照组人群具有较好的预测效果。结论抑郁症患者病程早期存在血浆氨基酸代谢紊乱;循环氨基酸或可用于抑郁症病情严重程度评价以及抑郁症初步诊断。

Measurement of plasma amino acid level in first-episode drug-naive depressive patients and its clinical significance

Objective To measure the plasma level of amino acids in first-episode drug-naive depressive patients and analyze its difference with that in controls and its possible clinical value for assessing the severity of depression.Methods Plasma level of amino acids was measured in 26 first-episode drug-naive depressive patients and 25 healthy controls using isotope internal standard in combination with mass spectrometry.Severity of depression was assessed according to the Hamilton Depression Scale-17(HAMD-17) and analyzed with the SPSS16.0 statistical package.Results The plasma levels of tryptophan,phenylalanine,lysine,methionine,γ-aminobutyricacid,α-aminoadipic acid,glutamine,ethanolamine and leucine were significantly higher in depressive patients than in healthy controls(P<0.05).The plasma levels of aspartate and β-aminoisobutyric acid were negatively correlated with the scores of HAMD-17 in depressive patients(P=0.045,0.006;r=-0.397,-0.521).Regression analysis showed that the prediction model consisted of tryptophan,cysteine,and glutamine had a rather good prediction efficacy for the plasma amino acid level.Conclusion Metabolic disorder of amino acids occurs in early depressive patients.Circulating amino acids can be used in assessing the severity of depression and in its preliminary diagnosis.