首发广泛性焦虑障碍患者血浆脑源性神经营养因子水平的动态观察

Dynamic level observation of brain-derived neurotrophic factor in patients with first-episode generalized anxiety disorder

目的了解首发广泛性焦虑障碍患者血浆脑源性神经营养因子（BDNF）变化规律。方法测定34例于2007年1—12月在湖州市第三人民医院就诊的广泛性焦虑障碍首发患者基线、帕罗西汀治疗6周末血浆脑源性神经营养因子水平，同时评定相应时点汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）分值，并与31名正常人（对照组）比较。结果首发广泛性焦虑障碍患者基线BDNF（80±51）ng／L，较对照组高，与基线HAMA、HAMD评分无显著相关性。治疗6周末（70±49）ng／L与HAMA、HAMD评分均存在显著相关性（分别为r=0．4，P=0；r=0．4，P=0）。6周末有效（含痊愈）组和无效组BDNF分别为（60±42）ng／L和（83±55）ng／L，无效组和对照组比较差异有统计学意义；痊愈组和非痊愈组BDNF水平分别为（59±52）ng／L和（73±49）ng／L，非痊愈组和对照组比较差异有统计学意义。结论首发GAD患者血浆BDNF水平在治疗前较正常人高，治疗达到痊愈的患者可能会降到正常水平。

Objective To examine the changing pattern of brain-derived neurotrophic factor （BDNF） in the patients with first-episode generalized anxiety disorder （GAD）. Methods The levels of plasma BDNF and the Hamilton anxiety scale （ HAMA ） and Hamilton depression scale （ HAMD ） scores were measured in 34 patients with first-episode GAD recruited from our hospital between January and December 2007. At baseline and Week 6, they were treated by paroxetine and compared with 31 healthy participants in the control group. Results The baseline level of BDNF [ （80 -51 ） ng/L] in the patients with first-episode GAD was higher than that in the control group and had no significant correlation with HAMA and HAMD scores. But at Week 6, the level of BDNF [ （70 ±49） ng/L] had significant correlations with HAMA and HAMD scores （ r = 0.4, P = 0 and r = 0.4, P = 0 respectively）. At Week 6, the levels of BDNF in the response group （including remission group） and ineffective group were （60±42） ng/L and （83 ± 55 ） ng/L respectively. And there was significant difference in the levels of BDNF between the ineffective and control groups. The levels of BDNF in the remission and non-remission groups were （59±52） ng/L and （73 ± 49 ） ng/L respectively. And there was significant difference in the levels of BDNF between the non-remission and control groups. Conclusion The pre-treatment levels of plasma BDNF in the patients with first-episode GAD are higher than those of healthy counterparts. But normal levels may be restored if the patients are cured.