亚甲基四氢叶酸还原酶多态性与老年卒中后抑郁的关联分析  

Association analysis of the MTHFR polymorphism and post-stroke depression in the elderly

作　　者：梅峰[1] 吴岩峰[2] 丁桂兵[2] 潘凤华[2] 陈亮[2] 吴晋[2] 

机构地区：[1]南京医科大学附属脑科医院,南京市210003 [2]南京医科大学第二附属医院

出　　处：《老年医学与保健》2016年第6期363-365,369,共4页Geriatrics & Health Care

基　　金：南京医科大学面上发展项目(2011NJMU148);南京医科大学重点发展项目(2011NJMU252);江苏省卫生厅科研项目(H201206)

摘　　要：目的探讨老年人群中亚甲基四氢叶酸还原酶多态性(MTHFR)基因C677T多态性与卒中后抑郁(PSD)的发病机制和疗效相关,但研究结果并不一致。本研究旨在探讨老年人群中MTHFR和PSD以及抗抑郁药反应之间的关联。方法本研究共纳入102例首次发病的急性脑卒中患者。在为期6个月的随访中,37例患者(36.3%)被诊断为患有PSD,设为观察组,另外65例设为对照组。两组均按照MTHFR基因C677T多态性进行基因分型。根据汉密尔顿抑郁评分量表的减分率来判断6周后的抗抑郁药物疗效。结果在病例组和对照组中,MTHFR基因C677T的T等位基因(OR=2.73;95%CI=1.11-6.67,P=0.04)以及C/T基因型(OR=3.42;95%CI=1.37-8.55,P=0.01)差异具有统计学意义。而在治疗有效和无效患者中,MTHFR基因C677T和基因型分布频率上差异无统计学意义(P>0.05)。结论 MTHFR C/T基因型与老年PSD的发病相关,该基因多态性与抗抑郁疗效并无显著联系。Objective To investigate the association of Methylenetetrahydrofolate reductase （MTHFR） with post-stroke depression （PSD） and antidepressant response in the elderly. Methods 102 senile cases with acute stroke for the first attack were recruited; after the follow-up for 6 months, 37 cases （36.3%） were diagnosed to be with PSD, making up the observation group while the left 65 cases made up the control group; cases in both groups were genotyped based on the MTHFR C677T polymorphism; the anti-depressant response over 6 weeks was measured according to the reducing score rate of Hamilton Depression Rating Scale. Results There existed a difference of statistical significance in T allele （OR=2.73; 95 %CI= 1.11-6.67, P=0.04） and C/T genotype （OR=3.42; 95 %CI = 1.37-8.55, P=0.01） of MTHFR C677T between observation group and control group; no difference of statistical significance was found in frequency of the MTHFR C667T allele and genotype distribution （P〉0.05） between the responders and non-responders. Conclusions The MTHFR C/T genotype is correlated with the occurrence of PSD while there exists no obvious correlation between the gene polymorphism and the antidepression effect

关 键 词：亚甲基四氢叶酸还原酶多态性 卒中后抑郁 抗抑郁药疗效 老年 

分 类 号：R749.13[医药卫生—神经病学与精神病学]