抑郁症自杀未遂患者血浆脑源性神经营养因子水平及相关分析

Plasma level of brain-derived neurotrophic factor and the related analysis in depressive patients with sui cide attempt

目的探讨血浆脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平与抑郁症患者自杀行为的相关性。方法采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)测定抑郁症自杀未遂患者(自杀未遂组,27例)、抑郁症无自杀行为患者(抑郁症组,33例)和正常对照者(对照组,30例)血浆BDNF水平,同时采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)和贝克抑郁自评量表(Beck self-rating de pression scale,BDI)评定抑郁症状。结果自杀未遂组血浆BDNF水平[(778.88±230.71)pg/mL]低于抑郁症组[(1055.64±191.00)pg/mL,P<0.001]和对照组[(1348.06±192.67)pg/mL,P<0.001];抑郁症组血浆BDNF水平低于对照组(P<0.001)。多因素Logistic回归分析表明血浆BDNF水平降低是与抑郁症自杀未遂相关的危险因素。ROC曲线分析显示抑郁症自杀未遂患者与抑郁症患者血浆BDNF水平的最佳切点值为806.16 pg/mL,其预测抑郁症自杀行为的灵敏度和特异度分别为66.7%和97.0%。结论血浆BDNF水平降低与抑郁症患者的自杀行为有关,是抑郁症患者自杀行为的生物学危险因素。

Objective To explore the association between brain-derived neurotrophic factor （BDNF） and suicidal behavior through analyzing and detecting the alteration of plasma BDNF level in depressive patients with suicide attempt. Methods Using enzyme-linked immunosorbent analysis （ELISA） to test the plasma level of BDNF in 27 suicidal depressed patients, 33 non-suicidal depressed patients and 30 normal controls. Meanwhile, the Hamilton Depression Scale （HAMD） and Beck Self-rating Depression Scale （BDI） were used to evaluate the severity of the symptoms. Results The Plasma level of BDNF in suicidal patients [（778.88±230.71）pg/mL] was significantly lower than non-suicidal depressed patients [（1055.64±191.00） pg/mL; P〈0.001] and normal controls [（1348.06±192.67）pg/mL; P〈O.O01], the plasma BDNF level in non-suicidal depressive patients was also significantly lower than normal controls （P〈0.001）. The multiple stepwise regression analysis showed that the decreased plasma level of BDNF was a risk factor of suicidal behavior in depression. The most suitable cut-off point of BDNF level between suicidal depression and non-suicidal depression groups was806.16pg/mL, the sensitivity=66.7 % ,specificity=97 %. Conclusion These results suggest that the decreased plasma level of BDNF is related to suicidal behavior in depressed patients and may be a biologically risk factor of suicidal behavior in depression.