双相障碍抑郁发作患者血清谷氨酸系统代谢紊乱特征及相关因素  

Characteristics and related factors of glutamate system dysfunction in depressive episode patients with bipolar disorder

作　　者：廖继武[1] 杨海华 王丝丝[1] 马萍[1] 李從睿 黄俏庭[1] 潘集阳[1] LIAO Jiwu;YANG Haihua;WANG Sisi;MA Ping;LI Congrui;HUANG Qiaoting;PAN Jiyang(Department of Psychiatry,The First Affiliated Hospital of Jinan University)

机构地区：[1]暨南大学附属第一医院精神医学科,广州510632 [2]暨南大学附属第一医院中心注射室

出　　处：《中国神经精神疾病杂志》2019年第9期540-544,共5页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨双相障碍抑郁发作患者外周血清中谷氨酸系统各指标变化的特点及其相关因素。方法选取50例双相障碍抑郁发作患者及48名正常对照,以汉密尔顿抑郁量表(Hamilton depression scale-17,HAMD-17)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估患者抑郁和焦虑症状,以酶联免疫吸附法测定被试血清谷胺酰胺(glutamine,Gln)、谷氨酸(glutamate,Glu)、γ-氨基丁酸(γ-aminobutyric acid,GABA)及谷氨酸脱羧酶(glutamic acid dehydrogenase,GAD)水平,计算Glu/GABA比值。结果双相障碍抑郁发作组较之对照组,血清Glu水平[(35.80±6.34)mg/L vs.(28.69±5.73)mg/L,t=4.68,P<0.01]及Glu/GABA[(6.18±1.40)vs.(5.06±1.29),t=3.44,P<0.01]增高,血清GABA水平[(5.09±0.71)μmol/L vs.(5.83±1.17)μmol/L,t=3.10,P=0.01]、GAD水平[(28.72±5.39)U/L vs.(35.78±7.22)U/L,t=4.46,P<0.01]降低。双相障碍抑郁发作组血清Glu水平与HAMD总分呈正相关(r=0.52,P=0.03),血清GABA水平与HAMD睡眠障碍因子分呈负相关(r=-0.38,P=0.04)。结论双相障碍抑郁发作患者存在Glu能神经元活性增强,GABA能神经元活性降低,兴奋性神经元与抑制性神经元功能失平衡。Objective To investigate the characteristics and related factors of glutamate(Glu) system dysfunction in depressive episode patients with bipolar disorder.Methods A total of 50 bipolar disorder patients with depressive episodes and 48 normal controls were enrolled.Depression and anxiety were assessed by Hamilton depression scale-17(HAMD-17) and Hamilton anxiety scale(HAMA).Serum Glutamine(Gln), Glu, GABA and glutamic acid decarboxylase(GAD) levels were measured by enzyme-linked immunosorbent assay(ELISA).Results Compared with the control group, serum Glu level [(35.80 ±6.34)mg/L vs.(28.69 ±5.73)mg/L, t =4.68, P <0.01] and Glu/GABA [(6.18 ±1.40) vs.(5.06±1.29), t=3.44, P<0.01] in bipolar depressive episode group increased significantly, when serum GABA level [(5.09±0.71) μmol/L vs.(5.83±1.17)μmol/L, t=3.10, P=0.01] and GAD level [(28.72±5.39)U/L vs.(35.78±7.22)U/L, t=4.46, P<0.01]decreased significantly.In the bipolar depressive episode group, the serum Glu level was positively correlated with the total HAMD score(r =0.52, P =0.03), while the serum GABA level was negatively correlated with the HAMD sleep disorder factor score(r=-0.38, P=0.04).Conclusion Glutamatergic neuron function may be enhanced when GABAergic neuron function may be decreased, and excitatory and inhibitory neurons were out of balance in depressive episode patients with bipolar disorder.

关 键 词：双相障碍 抑郁发作 谷氨酸 Γ-氨基丁酸 谷氨酸脱羧酶 

分 类 号：R749.4[医药卫生—神经病学与精神病学]