抑郁症患者脑源性神经营养因子蛋白及基因表达水平与自杀行为的关联分析

Association of brain-derived neurotrophic factor protein in peripheral blood and gene expression to suicidal behavior in patients with depression

目的:探讨抑郁症患者外周血脑源性神经营养因子(BDNF)蛋白和mRNA表达水平与自杀行为、抑郁症状的关联。方法:共纳入符合中国精神障碍分类与诊断标准第3版诊断标准的抑郁症患者65例,按有无自杀未遂行为分为自杀未遂组(n=31)、无自杀行为组(n=34),健康对照30名。采用汉密顿抑郁量表(HAMD)、Beck绝望量表(BHS)、自杀意念自评量表(SIOSS)评估病例组的抑郁、绝望与自杀意念;采用酶联免疫吸附法测定血清BDNF蛋白浓度,实时荧光定量聚合酶链式反应(PCR)法测定BDNF mRNA相对表达量。结果:自杀未遂组与无自杀行为组的BDNF蛋白浓度[(57.3±9.2)ng/mL,(76.0±25.7)ng/mL vs.(113.8±44.4)ng/mL,均P<0.05]与BDNF mRNA相对表达量[(0.2±0.0),(0.5±0.0)vs.(1.0±0.1),均P<0.05]均低于正常对照组,自杀未遂组的血清BDNF蛋白浓度和mRNA相对表达量低于无自杀组(P<0.05)。病例组(n=65)血清BDNF蛋白浓度与SIOSS总分(r=-0.24,P<0.01)呈负相关,与BDNF mRNA相对表达量(r=0.28,P<0.01)呈正相关;BDNF mR-NA相对表达量与HAM D总分(r=-0.46,P<0.01)、BHS总分(r=-0.42,P<0.01)、SIOSS总分(r=-0.43,P<0.01)呈负相关,与病程(r=0.19,P<0.05)呈正相关。结论:研究提示外周血BDNF蛋白和mRNA水平低可能是抑郁发作患者出现自杀行为的危险因素之一。

Objective： To explore the association of brain-derived neurotrophic factor （BDNF） protein in pe- ripheral blood and mRNA expression to suicidal behavior in patients with depression. Methods： Sixty-five patients with depression meeting the Chinese Classification and Diagnostic Criteria for＇ Mental Disorders, Third Edition （ CC- MD-3） criteria and 30 healthy controls were selected. The patients were divided into group with suicide attempts （ n = 31） and group without suicide attempts （n = 34）. The patients were assessed with the Hamilton Depression Scale （HAMD）, Beck Hopelessness Scale （BHS）, and Self-rating Idea of Suicide Scale （SIOSS） to evaluate the severity of depression symptoms, hopelessness, and suicide idea. In all subjects, the BDNF mRNA expression was measured using real-time quantitative polymerase chain reaction （PCR）, and the serum level of BDNF was detected with ELISA method. Results： BDNF protein [ （57.3 ± 9. 2） ng/mL, （76. 0 ± 25.7） ng/mL vs. （ 113.8 ± 44.4） ng/mL, Ps 〈 0.05 ] and mRNA expression [ （0. 2± 0. 0）, （0. 5 ± 0. 0） vs. （ 1.0± 0. 1）, Ps 〈 0. 05 ] were both lower in pa- tients with suicide attempts and patients without suicide attempts than in control group. Patients with suicide at- tempts had lower BDNF expression than those without suicide attempts （Ps 〈 0. 05）. In patients with depression （n =65）, the serum BDNF protein level was negatively correlated with SIOSS score （r = -0. 24, P 〈0. 01）, and was positively correlated with BDNF mRNA expression （ r = 0. 28, P 〈 0. 01 ）. The expression level of BDNF mRNA was negatively correlated with scores of HAMD （ r = - 0. 46, P 〈 0. 01 ）, BHS （ r = - 0.42, P 〈 0. 01 ） and SIOSS （r = -0.43, P 〈0. 01）, and was positively correlated to disease course （r =0. 19, P 〈0. 05）. Conclusion： The re- suits suggest that the decreased levels of brain-derived neurotrophic factor （BDNF） protein in peripheral blood and gene expression may be related to the suicidal behavior in patients with depression.