COMT基因多态性及社会心理因素与抑郁症伴慢性疼痛的相关性研究  

Association of COMT gene polymorphism and psychosocial factors with depression with chronic pain

作　　者：胡曼娜[1] 古力巴克然木·阿布拉[1] 张丞[1] 沈小琴 唐潇潇 邹韶红[1] Hu Manna;Guli Bakram·Abra;Zhang Cheng;Shen Xiaoqin;Tang Xiaoxiao;Zou Shaohong(Department of Clinical Psychology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Chin)

机构地区：[1]新疆维吾尔自治区人民医院临床心理科,乌鲁木齐830001

出　　处：《神经疾病与精神卫生》2022年第9期616-622,共7页Journal of Neuroscience and Mental Health

基　　金：新疆维吾尔自治区自然科学基金资助项目(2018D01C122);新疆维吾尔自治区人民医院院内科研项目(20160107)。

摘　　要：目的探讨儿茶酚胺氧位甲基转移酶(COMT)基因多态性及社会心理因素对抑郁症伴慢性疼痛的影响。方法纳入2018年1月至2019年12月在新疆维吾尔自治区人民医院临床心理科和疼痛科门诊就诊或住院治疗的292例抑郁症患者为研究对象。抽取所有患者空腹静脉血,通过TaqMan单核苷酸多态性(SNP)基因分型测序方法筛查COMT基因rs6269、rs4633位点的SNP。根据是否伴发慢性疼痛将患者分为研究组(141例)和对照组(151例),比较两组患者的一般资料、COMT基因多态性、社会支持评定量表(SSRS)得分、自我认同感量表(SIS)得分以及简易应对方式问卷(SCSQ)得分。采用整体疼痛评估量表(GPS)评估抑郁症伴慢性疼痛患者的疼痛程度。采用多因素Logistic回归分析抑郁症患者伴慢性疼痛的相关因素。采用Pearson相关分析社会心理因素与抑郁症伴慢性疼痛患者疼痛程度的相关性。结果两组患者性别、文化程度比较,差异有统计学意义(P<0.05)。研究组患者的SIS得分、SSRS得分、SCSQ中积极应对条目均分低于对照组,SCSQ中消极应对条目均分高于对照组,差异有统计学意义(P<0.01)。研究组COMT基因rs6269位点A等位基因频率高于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,SIS得分越高(OR=0.822,95%CI=0.749~0.903)、SSRS得分越高(OR=0.775,95%CI=0.704~0.855)、SCSQ中积极应对条目均分越高(OR=0.001,95%CI=<0.001~0.011)是抑郁症患者伴慢性疼痛的保护因素(P<0.05);女性(OR=16.557,95%CI=2.364~115.936)、小学及以下文化程度(OR=43.380,95%CI=4.297~437.978)、SCSQ中消极应对条目均分越高(OR=187.293,95%CI=10.826~3240.198)、COMT基因rs6269位点A等位基因频率越高(OR=2.442,95%CI=1.235~4.828)是抑郁症患者伴慢性疼痛的危险因素(P<0.05)。Pearson相关分析显示,SIS得分、SSRS得分、SCSQ中的积极应对条目均分与GPS条目均分呈负相关(r=-0.689、-0.677、-0.736;P<0.05),与SCSQ�Objective To investigate the relationship between catecholamine oxygen methyltransferase(COMT) gene polymorphism and psychosocial factors and depression with chronic pain.Methods From January 2018 to December 2019,a total of 292 patients were included in the outpatient and inpatient treatment of the clinical psychology and pain department of People ’s Hospital of Xinjiang Uygur Autonomous Region.Fasting venous blood was drawn from all the patients.Screen the COMT gene rs6269 and rs4633 for single nucleotide polymorphism(SNP) by TaqMan SNP genotyping and sequencing method.According to whether depression was accompanied by chronic pain was divided into study group(141 cases) and control group(151 cases).The general information,COMT gene polymorphism,Social Support Rating Scale(SSRS),Self-Identity Scale(SIS) and Simple Coping Style Questionnaire(SCSQ) scores of the two groups were compared.The Global Pain Assessment Scale(GPS) was used to assess the degree of pain in patients with chronic pain.Multivariate Logistic regression was used to analyze the related factors of depression patients with chronic pain.Pearson correlation was used to analyze the correlation between psychosocial factors and the degree of pain in patients with depression and chronic pain.Results There was significant difference in gender and education between the two groups(P <0.05).The positive coping scores in the study group’s SIS,SSRS,and SCSQ scales were lower than those in the control group,and the negative coping scores were higher than those in the control group.The difference was statistically significant(P <0.01).The frequency of the A allele at locus rs6269 of the COMT gene in the study group was higher than that in the control group,and the difference was statistically significant(P <0.05).Multivariate Logistics regression analysis showed higher SIS score(OR=0.822,95%CI=0.749-0.903),higher SSRS scores(OR=0.775,95%CI=0.704-0.855) and higher positive coping scores in SCSQ(OR=0.001,95%CI=<;0.001-0.011)were protective factors for depres

关 键 词：抑郁症 慢性疼痛 COMT基因 基因多态性 心理社会因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]