改良性电抽搐治疗对中国重症抑郁患者犬尿氨酸活性物质浓度影响的研究  

Effect of MECT on the concentration of kynurenine active substance in Chinese patients with severe depression

作　　者：邓书华[1] 谢焕山 王占璋[1] 卢浩扬[1] 陈宏镇 李璐[1] 张沐钦 张晓琼 尚德为[1] 温预关[1] DENG Shuhua;XIE Huanshan;WANG Zhanzhang;LU Haoyang;CHEN Hongzhen;LI Lu;ZHANG Muqin;ZHANG Xiaoqiong;SHANG Dewei;WEN Yuguan(The Affiliated Brain Hospital of Guangzhou Medical University,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders,Guangzhou 510370,China;The Center of Chronic Disease Control in Zhuhai,Zhuhai 519000,China)

机构地区：[1]广州医科大学附属脑科医院,广东省精神疾病转化医学工程技术研究中心,广东广州510370 [2]珠海市慢性病防治中心,广东珠海519000

出　　处：《广东药科大学学报》2020年第3期408-412,共5页Journal of Guangdong Pharmaceutical University

基　　金：广东省医院药学研究基金资助项目(2016MZ04);广州市卫生计生科技一般引导项目(20181A011044,20191A011040);广州市医学重点学科建设资金资助项目(2017-2019);广东省科技计划项目(2019B030316001);广东省中医药局科研项目(20201272);广州市科技计划项目(201805010009)。

摘　　要：目的探讨改良性电抽搐治疗(MECT)对重症抑郁患者犬尿氨酸活性物质浓度的影响。方法分别收集20例健康志愿者、16例重症抑郁患者(MDD)MECT治疗前后的血清样本,采用LC-MS/MS法测定血清中色氨酸(TRP)、犬尿氨酸(KYN)和犬尿喹啉酸(KYNA)的浓度,用临床总体印象量表(CGI)来评定患者临床整体改善情况。结果健康志愿者TRP、KYN和KYNA浓度平均值分别为12091.7、328.2和4.10 ng/mL,重症抑郁患者MECT治疗前后TRP、KYN和KYNA的浓度平均值分别为12901.9、271.0、2.2 ng/mL和11029.3、272.8、4.1 ng/mL。重症抑郁患者MECT治疗后TRP明显降低,KYNA明显升高(均为P<0.05),CGI评分显著降低(P<0.05);与健康志愿者相比,抑郁患者MECT治疗前KYNA明显低下(P<0.01),MECT治疗后各指标差异无统计学意义(P>0.05)。结论MECT能明显升高重症抑郁患者血清中KYNA浓度,提示MECT治疗重症抑郁患者可能通过影响犬尿氨酸代谢通路中KYNA水平发挥作用。Objective To explore the influence of modified electroconvulsive therapy(MECT)on the concentration of kynurenine active substance in patients with severe depression.Methods Serum samples of 20 healthy volunteers and 16 patients with severe depression(MDD)before and after MECT were collected.The concentrations of Trp,KYN and KYNA in serum were measured by LC-MS/MS,and the overall clinical improvement was evaluated by clinical global impression(CGI).Results The mean concentrations of Trp,KYN and KYNA in healthy volunteers were 12091.7,328.2 and 4.10 ng/mL,respectively.The mean concentrations of Trp,KYN and KYNA in patients with severe depression before and after MECT were 12901.9,271.0,2.2 ng/mL and 11029.3,272.8 and 4.1 ng/mL,respectively.After MECT treatment,Trp decreased,KYNA increased significantly,and CGI score decreased significantly in patients with severe depression.Compared with healthy volunteers,KYNA was lower in depressive patients before MECT treatment,and there was no significant difference in all indexes after MECT treatment.Conclusion MECT can significantly increase the serum KYNA concentration of patients with severe depression,suggesting that MECT may modulate the kynurenine metabolic pathway.

关 键 词：重症抑郁症 MECT 犬尿氨酸活性物质 犬尿喹啉酸 

分 类 号：R749[医药卫生—神经病学与精神病学]