脑源性神经营养因子基因多态性对帕罗西汀治疗2型糖尿病伴抑郁、焦虑症状患者疗效的影响

Effects of BDNF Gene Polymorphism on Therapeutic Efficacy of Paroxetine in the Treatment of Depression and Anxiety in Patients with Type 2 Diabetes

目的:探讨脑源性神经营养因子(BDNF)基因多态性对帕罗西汀治疗2型糖尿病伴抑郁、焦虑症状患者疗效的影响。方法:选择52例血糖控制不理想的2型糖尿病伴有抑郁、焦虑症状的患者,测定其BDNF基因类型,并按照基因类型分组,各组患者均在常规降糖治疗基础上使用帕罗西汀,每日晨服1次,每次20 mg,疗程4周。观察并比较各组患者治疗前后汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分和血糖水平。结果:携带Met/Met基因患者12例,占23.08%;Val/Val基因患者15例,占28.85%;Val/Met基因患者25例,占48.08%。不同基因组患者治疗后抑郁、焦虑症状均有改善,HAMD、HAMA每周的评分与上一周比较,差异均有统计学意义(P<0.01),但组间同期比较差异无统计学意义(P>0.05)。治疗后各组血糖均较治疗前显著下降(P<0.05),但各组间比较差异无统计学意义(P>0.05)。结论:帕罗西汀能有效改善2型糖尿病患者的抑郁、焦虑症状,促进血糖的控制,BDNF基因多态性与帕罗西汀疗效可能无相关性。

OBJECTIVE： To investigate the effects of BDNF gene polymorphism on therapeutic efficacy of paroxetine in the treatment of depression and anxiety in patients with type 2 diabetes. METHODS： Types of BDNF gene were determined. 52 type 2 diabetes patients with depression and unsatisfactory blood glucose control were divided into several groups. On the basis of conven- tional hypoglycemic treatment, those groups were treated with paroxetine 20 mg per time each morning for 4 weeks. Changes of Hamilton depression scale （HAMD） and Hamilton anxiety scale （HAMA） were observed before and after treatment. RESULTS： 12 patients possessed Met/Met gene, accounting for 23.08% ; 15 patients possessed Val/Val gene, accounting for 28.85% ; 25 patients possessed Val/Met, accounting for 48.08%. The symptoms of depression were all improved in different gene groups. The scores of both HAMD and HAMA had statistical significance before and after treatment （P〈0.01）; but there was no statistical significance among groups （P〉 0.05）. CONCLUSIONS： Pamxetine effectively improve the symptom of depression and blood glucose control in type 2 diabetic patients. It is not suggested that BDNF polymorphism associates with therapeutic efficacy of pamxetine.