伴抑郁症状的慢性丙型肝炎患者的血清BDNF表达与生存质量的相关性分析  

Correlation between serum levels of BDNF and life quality in patients with chronic hepatitis C complicated with depressive symptoms

作　　者：曾妍[1] 杨健[2] 况利[1] 

机构地区：[1]重庆医科大学附属第一医院心理卫生中心,重庆400016 [2]重庆医科大学附属第二医院消化内科,重庆400010

出　　处：《第三军医大学学报》2011年第21期2274-2277,共4页Journal of Third Military Medical University

基　　金：重庆市卫生局重点项目(2009-1-55);重庆市科委资助项目(CSTC2007BB5318)~~

摘　　要：目的研究抗抑郁治疗前后慢性丙型肝炎(chronic Hepatitis C,CHC)合并抑郁患者的血清人脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平与其生存质量的关系。方法收集重庆医科大学附一院心理卫生中心、附二院消化内科门诊及住院部CHC患者共46例,其中CHC合并抑郁患者23例,随机给予抗病毒加抗抑郁剂治疗或单纯抗病毒治疗,CHC未伴抑郁患者25例给予单纯抗病毒治疗,并收集重庆医科大学健康就读学生、附一院进修生及职工共30例做正常对照组。分别收集各组治疗前和治疗6个月后血清,ELISA法测定其BDNF水平,肝病患者生命质量测定量表(quality of life scale for patients of liver disease,QOL-LD)和汉密尔顿抑郁量表(hamilton depression scale,HAMD)分别评估患者生存质量和抑郁程度,SPSS 18.0进行统计学分析。结果①CHC合并抑郁组抗抑郁治疗后QOL-LD量表中躯体功能、心理功能、症状副作用和总量表分值明显高于治疗前(P<0.05),HAMD量表评分较治疗前明显下降(P<0.01);②HAMD量表、QOL-LD量表与血清BDNF水平呈显著负相关(r=-0.663,P<0.05;r=-0.704,P<0.05);③治疗后抗抑郁治疗组血清BDNF水平升高(t=-10.582,P<0.01),未抗抑郁治疗组和单纯CHC组则无明显变化(P>0.05)。结论慢性丙型肝炎患者血清BDNF水平会随着抑郁症状改善上升,抗抑郁治疗有助于提高患者的生存质量。Objective To investigate the correlation between serum levels of brain-derived neurotrophic factor（BDNF） and life quality in patients with chronic hepatitis C（CHC） complicated with depressive symptoms before and after antidepressive therapies.Methods Forty-six patients with CHC from inpatients and outpatients of the Affiliated Hospitals of Chongqing Medical University were enrolled.Twenty-three of the 46 patients complicated with depressive symptoms were separately treated with antidepressants and antiviral or antidepressants alone,while the other 25 CHC patients without depressive symptoms were treated with antiviral alone.Thirty normal controls were enrolled from healthy students,visiting scholars and staffs from the First Affiliated Hospital of Chongqing Medical University.Serum samples were collected from all the patients and normal controls before and 6 months after treatment.ELISA was applied to detect serum levels of BDNF.Life quality and depression were assessed by quality of life scale for patients of liver disease（QOL-LD） and Hamilton Depression Scale（HAMD）,respectively.All data were analyzed by SPSS18.0.Results ① QOL-LD scores of physical functions,psychological functions,symptoms/side effects and the score of the total scale in CHC patients with depressive symptoms after antidepressive therapy were significantly higher than those before the therapy（P〈0.05）,while patients＇ HAMD scores were significantly decreased after the treatment（P0.01）.② QOL-LD and HAMD scores were negatively correlated with serum levels of BDNF（r=-0.663,P〈0.05;r=-0.704,P〈0.05）;③ The serum levels of BDNF increased in CHC patients with depressive symptoms after treated by antidepressants and antiviral（t=-10.582,P0.01）,while no significant changes were observed in CHC patients with depressive symptoms treated by antiviral therapy alone and CHC patients without depressive symptoms（P〈0.05）.Conclusion Serum levels of BDNF increase following the improvement of depressive symptoms in CHC

关 键 词：HCV 抑郁 生存质量 BDNF 

分 类 号：R512.63[医药卫生—内科学] R749.21[医药卫生—临床医学]