血清脑源性神经营养因子对帕罗西汀治疗惊恐障碍效果的影响

Serum brain-derived neurotrophic factor levels in patients with panic disorder:As a biological predictor of response to paroxetine

目的:探讨脑源性神经营养因子(BDNF)在帕罗西汀治疗惊恐障碍中的可能作用。方法:接受帕罗西汀治疗12周的惊恐障碍患者45例(治疗组),按治疗前后汉密尔顿焦虑量表(HAMA)减分率分为有效组(≥50%,29例)和无效组(<50%,16例)。采用惊恐相关症状量表(PASS)、17项汉密尔顿抑郁量表(HAMD)、HAMA、临床总体印象量表(CGI)评定疾病严重程度和改善程度;采用酶联免疫吸附法测定其血清BDNF浓度,并与30名正常对照者(对照组)比较;对治疗组的血清BDNF浓度与各相关因素进行Spearman相关分析。结果:有效组BDNF水平高于无效组和正常对照组(P<0.05),无效组的BDNF水平则低于正常对照组(P<0.05);治疗组血清BDNF水平治疗后的PASS分值(r=-0.540,P=0.000)和HAMA分值(r=-0.491,P=0.001)呈负相关,与治疗前后HAMA评分差值(r=0.425,P=0.004)和PASS评分差值(r=0.522,P=0.000)呈正相关。结论:外周循环中BDNF水平减少在惊恐障碍的病理生理机制中起着重要的作用,可能是帕罗西汀疗效的预测因素。

OBJECTIVE To evaluate the serum braiwderived neurotrophic factor（BDNF） levels in patients with panic disor- der（PD）. METHODS A total of 45 PD patients and 30 healthy controls were recruited. The Panic Associated Symptom Scale （PASS）, Hamilton Rating Scale for Depression（HAMD 17）, Hamilton Rating Scale for Anxiety（HAMA）, and Clinical Global Impression Scale（CGI） were used to evaluate the patient＇s symptoms. After 12 weeks oral administration of paroxetine, the pa- tients were divided into two groups according to the reduced rate of HAMA： a good outcome group and a poo〉outcome group. There were 29 good responders and 16 poor responders. The serum level of BDNF was detected with ELISA method. RESULTS The serum BDNF levelsof the patients with poor response were significantly lower than those of the patients with good re- sponse and healthy controls（P,~l）. 05）. In patients, the serum BDNF was negatively correlated to the mean PASS（r = - 0. 540, P = 0. {）（）tl）and HAMA score after treatment （r = -0. 235, P = 0. 006）. The serum BDNF was positive correlated to the score difference of HAMA and PASS before and after treatment （r = 0. 425, P = 0. 004, r = 0. 522, P = 0. 000 respectively）. CONCLUSION The results suggest that the decreased BDNF in peripheral blood is related to the pathophysiology of PD pa- tients. Serum BDNF may be a biological predictor of response to paroxetine.