抑郁症患者的血清谷氨酸及γ-氨基丁酸系统水平  

Levels of serum glutamate and gamma-aminobutyric acid system in patients with depression

作　　者：廖继武[1] 王丝丝[1] 杨海华 温金峰 马萍[1] 李從睿 黄俏庭[1] 潘集阳[1] LIAO Jiwu;WANG Sisi;YANG Haihua;WEN Jinfeng;MA Ping;LI Congrui;HUANG Qiaoting;PAN Jiyang(Department of Psychiatry,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Guangdong 999 Brain Hospital,Guangzhou 510080,China)

机构地区：[1]暨南大学附属第一医院,广州510632 [2]广东三九脑科医院,广州510080

出　　处：《中国心理卫生杂志》2020年第2期87-91,共5页Chinese Mental Health Journal

摘　　要：目的:测量抑郁症发作期与缓解期血清谷氨酸(Glu)、γ-氨基丁酸(GABA)系统水平,探讨这些递质在抑郁症病理机制中的作用。方法:选取符合DSM-5诊断标准的抑郁症发作期患者47例,缓解期患者34例及31例正常对照,以汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)评估患者抑郁、焦虑症状,酶联免疫吸附法测定被试血清Glu、 GABA、谷胺酰胺(Gln)及谷氨酸脱羧酶(GAD)水平。结果:与缓解期组及对照组相比,抑郁症发作期组血清Glu水平[(35.3±6.1)mg/L、(28.0±5.4)mg/L vs.(28.7±5.7)mg/L,P<0.001]及Glu/GABA[(6.3±1.3)、(5.2±1.8)vs.(5.1±1.3),P<0.05]较高,而血清GABA[(5.1±0.7)μmol/L,(5.9±0.9)μmol/L, vs.(5.8±1.2)μmol/L,P<0.01]、GAD[(29.7±6.0)U/L,(36.4±5.3)U/L vs.(35.8±7.2)U/L,P<0.001]降低,但缓解期组与对照组间各物质水平差异无统计学意义(P>0.05);发作期组血清GABA水平与HAMA总分(r=-0.34,P<0.05)、HAMD总分(r=-0.46,P<0.01)及抑郁核心症状分(r=-0.32,P<0.05)呈负相关。结论:本研究提示Glu能和GABA能神经元功能异常可能是抑郁症病理机制之一。Objective:To measure serum glutamate(Glu) and gamma-aminobutyric acid(GABA) levels in episodes and remission of depression,and to explore the role of these transmitters in the pathogenesis of depression.Methods:Forty-sevenpatients with depression in onset stage,34 patients with depression in remission stage and 31 normal controls were selected.The diagnosis was made according to the definition and criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5).The symptoms of depression and anxiety were assessed by Hamilton Depression Scale(HAMD) and Hamilton Anxiety Scale(HAMA).The levels of serum Glu,GABA,Glutamine(Gln) and Glutamate Decarboxylase(GAD) were measured by ELISA.Results:Compared with the remission stage of depression and the control group,the serum Glu level [(35.3±6.1)mg/L,(28.0±5.4)mg/L vs.(28.7±5.7)mg/L,P<0.001]and Glu/GABA [(6.3±1.3),(5.2±1.8)vs.(5.1±1.3),P=0.035]were higher in the onset stage group,while the serum GABA[(5.1±0.7)μmol/L,(5.9±0.9)μmol/Lvs.(5.8±1.2)μmol/L,P=0.001]、GAD[(29.7±6.0)U/L,(36.4±5.3)U/L vs.(35.8±7.2)U/L,P<0.001]decreased,but there was no significant difference in the levels of substances between the remission group and the control group(P>0.05).The level of serum GABA inonset group was negatively correlated with HAMA total score(r=-0.34,P<0.05),HAMD total score(r=-0.46,P<0.01) and depression core symptom score(r=-0.32,P<0.05).Conclusion:This study suggests that dysfunction of Gluergic and GABA neurons may be one of the pathological mechanisms of depression.

关 键 词：抑郁症 谷氨酸 Γ-氨基丁酸 谷氨酸脱羧酶 

分 类 号：R749.91[医药卫生—神经病学与精神病学]