首发抑郁症伴焦虑特征患者血清脑源性神经因子水平及临床意义

Levels of Serum Brain-Derived Neurothrophic Factor in First-Episode Depression Patients with Anxiety Symptoms and Its Clinical Significance

摘要: 目的：探讨首发抑郁症伴焦虑特征患者的血清脑源性神经营养因子变化水平的关系及临床意义。方法：选取2016年7月至2018年11月就诊于重庆医科大学附属大学城医院门诊和住院的首发抑郁症患者90例(研究组)和体检中心健康人员90例(健康对照组)作为研究对象，将研究组按患者焦虑症状的严重程度分为一般焦虑组(14 < HAMA ≤ 21)和明显焦虑组(HAMA > 21分)，采用酶联免疫吸附法检测血清中BDNF水平，采用HAMD-17、HAMA、CGI评定临床症状及病情严重程度。结果：研究组患者血浆BDNF水平明显低于健康对照组(P < 0.05)。研究组各亚组进一步比较，明显焦虑组年龄低于一般焦虑组(P < 0.05)；明显焦虑组HAMD总分、阻滞因子评分、睡眠障碍因子评分以及CGI-S评分均高于一般焦虑组(P < 0.05)；经Pearson相关分析，基线血清BDNF水平与CGI评分呈负相关(r = −0.221, P = 0.037)。ROC曲线分析显示，BDNF诊断首发伴焦虑症状抑郁症患者的最佳切点值为12.285 ug/L，诊断灵敏度和特异度分别为41.1%和95.6%，ROC曲线下面积为0.747。结论：首发抑郁症伴焦虑特征患者血清BDNF水平与疾病严重程度呈负相关，低年龄、睡眠障碍、阻滞为首发抑郁症患者伴焦虑症状严重程度的尽管，目前大量研究已证实危险因素。

Abstract: Objective: To measured the levers of serum brain-derived neurothrophic factor in first-episode depression patients with anxiety symptoms, and to explore its clinical significance. Methods: From July 2016 to November 2018, 90 first-episode depression patients (research group) treated in University-Town Hospital of Chongqing Medical University and 90 health checkers (health control group) in the physical examination center were selected as the study objects. The research group was divided into general anxiety group (14 < HAMA ≤ 21) and obvious anxiety group (HAMA > 21 points) according to the severity of anxiety symptoms. The levers of BDNF in the serum of the sub-jects were detected by enzyme-linked immunosorbent assay. We used HAMD-17, HAMA, CGI to as-sess clinical symptoms and severity of illness. Results: The plasma BDNF level of the study group was significantly lower than that of the healthy control group (P < 0.05). The subgroups of the study group were further compared. The age of the obvious anxiety group was lower than that of the general anxiety group (P < 0.05); the total score of HAMD, block factor score, sleep disorder factor score and CGI-S score of the obvious anxiety group were higher than those of the general anxiety group (P < 0.05); Pearson correlation analysis showed that baseline serum BDNF level was negatively correlated with CGI score (r = −0.221, P = 0.037). ROC curve analysis showed that the best cut-point value of BDNF for diagnosing first-episode depression patients with anxiety symp-toms was 12.285 ug/L, the diagnostic sensitivity and specificity were 41.1% and 95.6%, respec-tively, and the area under the ROC curve was 0.747. Conclusion: The level of serum BDNF in patients with first-onset depression with anxiety symptoms is negatively correlated with the severity of the disease. Low age, sleep disturbance, and blockade are risk factors for the severity of first-on depression with anxiety symptoms.