伴失眠症状老年抑郁症病人血清神经营养因子及甲状腺激素水平变化  

Changes of neurotrophic factor and thyroid hormone levels in elderly depressed patients with insomnia symptoms

作　　者：贾雪 张云淑[2] 张丽丽[2] 黄志靖 栗克清[2] JIA Xue;ZHANG Yunshu;ZHANG Lili;HUANG Zhijing;LI Keqing(Graduate School of North Chnia University of Psychology and Mental Health,Tangshan,Hebei 063210,China;Hebei Provincial Mental Health Center Psychiatry Department,Hebei Key Labo-ratory of Major Mental and Behavioral Disorders,The Sixth Clinical Medical College of Hebei University,Baoding,Hebei 071000,China)

机构地区：[1]华北理工大学心理与精神卫生学院,河北唐山063210 [2]河北省精神卫生中心精神科、河北省重大精神与行为障碍疾病研究重点实验室、河北大学第六临床医学院,河北保定071000

出　　处：《安徽医药》2025年第1期109-113,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河北省财政厅老年病防治项目(361014)。

摘　　要：目的探讨伴失眠症状老年抑郁症病人脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、胶质源性神经营养因子(glial cell line-derived neurotrophic factor,GDNF)、甲状腺激素(thyroid hormone,TH)水平变化。方法回顾性分析于2016年7月至2018年3月河北省第六人民医院收治的124例老年抑郁病人年的临床资料,根据有无失眠症状分为伴失眠症状组65例、无失眠症状组59例。比较两组血清BDNF、GDNF、TH水平差异,并对老年抑郁症失眠的影响因素进行分析。结果伴失眠症状组BDNF水平低于无失眠症状组[981.09(924.37,1031.63)ng/L,1062.64(1012.79,1137.61)ng/L],差异有统计学意义(P<0.05)。伴失眠症状组GDNF水平低于无失眠症状组[0.41(0.31,0.50)ng/L,0.56(0.44,0.69)ng/L],差异有统计学意义(P<0.05)。相比于无眠症状组,伴失眠症状组三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)表达水平及促甲状腺激素(TSH)表达水平,差异无统计学意义(P>0.05)。此外相关性分析显示,BDNF、GDNF水平之间呈正相关(P<0.05)。二元logistic回归分析结果表明血清BDNF、GDNF是伴发失眠症状的保护因素(BDNF:OR=0.99;GDNF:OR=0.01)。结论提高血清BDNF和GDNF水平至正常水平可能成为改善老年抑郁失眠的潜在途径。Objective To investigate the changes in the levels of brain-derived neurotrophic factor(BDNF),glial cell line-derived neurotrophic factor(GDNF),and thyroid hormone(TH)in elderly patients with comorbid insomnia symptoms and depression.Methods The clinical data of 124 patients with depression admitted to The Sixth Clinical Medical College of Hebei University from July 2016 to March 2018 were retrospectively analyzed.The patients were divided into two groups:a group with comorbid insomnia symptoms(n=65)and a group without insomnia symptoms(n=59).The differences in serum BDNF,GDNF,and TH levels were compared between the two groups,and the factors influencing insomnia in elderly depression were analyzed.Results The levels of BDNF in patients with insomnia were significantly lower than those without insomnia[981.09(924.37,1031.63)ng/L,1062.64(1012.79,1137.61)ng/L,P<0.05].The levels of GDNF in patients with insomnia were significantly lower than those without insomnia[0.41(0.31,0.50)ng/L,0.56(0.44,0.69)ng/L,P<0.05,P<0.05].Compared with the insomnia group,the expression levels of triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3),free Thyroid hormone(FT4)and thyroid-stimulating hormone(TSH)in patients with insomnia,there was no statistical significance(P>0.05).In addition,there was a strong correlation between the levels of BDNF and GDNF(P<0.05).Multiple Logistic regression analysis showed that serum BDNF and GDNF were protective factors of insomnia(BDNF:OR=0.991;GDNF:OR=0.008).Conclusion Elevating serum BDNF and GDNF levels to normal ranges can potentially serve as a promising avenue for improving insomnia in elderly patients with depression.

关 键 词：抑郁症 入睡和睡眠障碍 脑源性神经营养因子 胶质源性神经营养因子 甲状腺激素 老年人 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R740[医药卫生—临床医学]