不同临床相双相障碍患者血液NMDA受体NR1亚基mRNA的表达  

Expression of NMDA receptor NR1 subunit mRNA in patients with different clinical phases of 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] 温金峰 LIAO Jiwu;YANG Haihua;WANG Sisi;MA Ping;LI Congrui;HUANG Qiaoting;PAN Jiyang;WEN Jinfeng(Department of Psychiatry,the First Affiliated Hospital of Jinan University,Guangzhou 510632,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3期170-175,共6页Chinese Mental Health Journal

摘　　要：目的:探讨谷氨酸(Glu)能神经递质及传递功能异常在双相障碍病理机制中的作用。方法:选取符合ICD-10诊断标准的双相障碍抑郁发作期患者35例,躁狂发作期患者33例,缓解期患者28例及40例正常对照,用汉密顿抑郁量表(HAMD-17)、汉密顿焦虑量表(HAMA)、贝克-拉范森躁狂量表(BRMS)评估被试临床症状,以酶联免疫吸附法测定血清Glu水平,以RT-PCR技术检测NR1亚基mRNA表达水平。结果:抑郁发作期组、躁狂发作期组血清Glu水平[(35.3±6.1)mg/L,(35.8±6.3)mg/Lvs.(27.8±5.4)mg/L,(28.6±5.7)mg/L,P<0.01]及NR1亚基mRNA水平[(1.6±0.4),(1.4±0.3)vs.(0.7±0.4),(0.6±0.5),P<0.01]高于缓解期组及对照组;抑郁发作期组血清Glu水平与HAMD总分呈正相关(r=0.58,P<0.05),躁狂发作期组NR1亚基mRNA水平与BRMS总分呈正相关(r=0.42,P<0.05)。结论:双相障碍疾病发作期可能存在Glu能神经递质水平紊乱及NR1亚基表达异常,在疾病缓解期基本恢复正常。Objective:To explore the role of Glu neurotransmitter and transmission dysfunction in the pathogenesis of bipolar disorder.Methods:Thirty-five patients with bipolar depression,33 patients with manic episode,28 patients with remission and 40 normal controls were selected.The clinical symptoms were assessed with the Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA)and Beck-lafensohn manic scale(BRMS).The serum Glu level was measured with ELISA and the expression of NR1 mRNA was detected with RT-PCR.Results:The serum Glu level[(35.3±6.1)mg/L,(35.8±6.3)mg/L vs.(27.8±5.4)mg/L,(28.6±5.7)mg/L,P<0.01]and NR1 subunit mRNA[(1.6±0.4),(1.4±0.3)vs.(0.7±0.4),(0.6±0.5),P<0.01]were higher in the bipolar depression group and the manic group than in the remiss group and the control group.The levels of serum Glu in bipolar depressive episode group were positively correlated with the total scores of HAMD(r=0.58,P<0.05),the level of NR1 subunit mRNA in manic episode group was only positively correlated with the total score of BRMS(r=0.42,P<0.05).Conclusion:It suggests that the dysfunction of gluergic neurotransmitter level and the abnormal expression of NR1 subunit may exist in bipolar disorder both in depression and manic episode,the degree of abnormal is similar,and it will return to normal in the remission stage.

关 键 词：双相障碍 抑郁发作 躁狂发作 N-甲基-D-天门冬氨酸受体 

分 类 号：R749.4[医药卫生—神经病学与精神病学]