5-HTTLPR与卒中后抑郁及单相抑郁病因和疗效的关联分析

A Study on Association between Serotonin Transporter Gene-linked Polymorphic Region(5-HTTLPR) and the Etiopathogenisis and Therapeutic Effect of Post-stroke Depression and Unipolar Depression

目的探讨我国汉族人群卒中后抑郁(post-stroke depression,PSD)及单相抑郁(unipolar depression,UD)患者病因和疗效与5-羟色胺转运蛋白启动子区基因多态性(serotonin transporter gene-linked polymorphic,5-HTTLPR)之间的关系。方法以45例PSD及41例UD患者作为研究对象,以149名正常人作对照,应用聚合酶链式反应(polymerase chain reaction,PCR)扩增技术测定所有研究对象的5-HTTLPR的基因型和等位基因,PSD和UD患者组患者使用氟西汀治疗12周,在基线及12周治疗末时使用汉密尔顿抑郁量表(Hamilton depressive scale,HAMD)-17项评定疾病严重程度及疗效。结果5-HTTLPR的3种基因型(S/S、S/L和L/L)和等位基因(S和L)在PSD组、UD组和正常对照组之间的分布差异无统计学意义;PSD和UD组S/S纯合子与S/L杂合子及L/L纯合子的基线评分相比差异具有统计学意义;12周治疗后两组患者治愈组和未治愈组之间S/S与S/L和L/L基因型、S和L等位基因分布具有统计学差异。结论5-HTTLPR与PSD及UD均无显著关联,S/S基因型患者可能抑郁症状较重,12周治疗后携带S/S基因型和S等位基因患者的临床痊愈率较低。

Objective To investigate the possible association of serotonin transporter gene-linked polymorphic region(5-HTTLPR) and the etiopathogenisis as well as therapeutic effect of post-stroke depression(PSD) and unipolar depression(UD) in Chinese Han population.Methods 45 patients with PSD,41 patients with UD and 149 healthy controls were enrolled in our case-control study.The genotypes and alleles of 5-HTTLPR were detected with PCR.Then the patients with PSD and UD were treated by fluoxetine for 12 weeks.The severity of symptoms and the responses to fluoxetine were rated by the Hamilton Rating Scale for Depression(HAMD-17) on baseline and the 12th weeks.Results There is no significant differences in genotype(S/S,S/L and L/L) and allele(S and L) frequencies of 5-HTTLPR among PSD,unipolar depression and control group.Patieons with S/S genotype had more severe symptoms than those with S/L and L/L.After 12 weeks of treatment,there are significant differences in genotype(S/S,S/L and L/L) and allele(S and L) frequencies of 5-HTTLPR between cured and uncured group.Conclusion 5-HTTLPR may not be associated with PSD and UD in the Chianese Han population.Patient with S/S genotype may be have the more server symptom.After 12 weeks of treatment,patients with S/S genotype and S allele frequency had lower rate of clinical recovery.