抑郁症患者BDNF270C/T基因多态性与抗抑郁药物疗效的相关性研究

Polymorphism of 270C/T in BDNF gene and efficacy of antidepressant therapy in patients with depression

目的了解抑郁症患者BDNF 270C/T基因多态性与抑郁症易感性疗效的相关性。方法将符合DSM-IV和CCMD-3诊断标准的汉族275例抑郁症患者以随机数字表法分为文拉法辛治疗组和帕罗西汀治疗组,并以同期健康体检者202例作为对照。收集一般人口学资料;对抑郁症患者在基线、治疗后1、2、4及6周末采用汉密尔顿抑郁量表(HAMD17项)总分和减分率来衡量疗效;治疗前和治疗6周后分别抽取静脉血(对照组在体检时),采用PCR-RFLP分析技术测定BDNF 270C/T基因多态性。结果文拉法辛治疗组与帕罗西汀治疗组6周末治疗疗效的差异无统计学意义。文拉法辛治疗组6周末痊愈者和非痊愈者BDNF270C/T基因型和等位基因频率分布的差异无统计学意义,痊愈组BDNF 270C/C频率较健康对照组低,C/T的频率高,等位基因C的频率低,T的频率高;帕罗西汀治疗组6周末痊愈者和非痊愈者BDNF 270C/T基因型和等位基因频率分布的差异无统计学意义,非痊愈组BDNF 270C/C的频率较健康对照组高,C/T的频率低,等位基因C的频率高,T的频率低。文拉法辛治疗组和帕罗西汀治疗组疗效差异和BDNF 270C/T基因多态性均无关联。结论 BDNF 270C/T并非抑郁症的易感基因,文拉法辛和帕罗西汀的6周疗效和BDNF 270C/T、多态性均无关联。

Objective To investigate the relationship between polymorphism of 270C/T in brain- derived neurotroph-ic- factor （BDNF） gene and efficacy of antidepressant therapy in patients with depression. Methods Two hundred and seventy five Han- ethnic patients with depression who met the diagnosis criteria of CCMD- 3 and DSM- IV were randomly assigned to re-ceive anti- depressive agent venlafaxine or paroxtine, and 202 healthy subjects served as controls. The general information in-cluding gender, age, education levels, occupation and the marriage were col ected. The severity of depression was evaluated with HAMD- 17 scale on the baseline and the end of week 1, 2, 4, 6 after treatment. The therapeutic efficacy was judged by mea-suring of HAMD total score and the reduction rate. Serum BDNF concentration was detected with ELISA before and 6 weeks after antidepressant therapy. The genetic polymorphism of 270C/T BDNF gene was detected by PCR- RFLP. Results There was no significant difference in remission rate between venlafaxine group and paroxtine group. There was no difference in BDNF 270C/T gene types and al ele distribution frequency between responsive patients or non- responsive patients both in venlafaxine and paroxtine groups at the end of week 6. Compared to healthy controls, the remission patients had lower rate of BDNF270C/C, higher rate of C/T, lower rate of al ele C and higher rate of al ele T. Compared to the healthy controls, non- remission patients had higher rate of BDNF 270C/C, lower rate of C/T, higher rate of allele C and lower rate of al ele T. The efficacy of antidepressants was not correlated with the genetic polymorphism of BDNF 270C/T both in venlafaxine and paroxtine groups. Conclusion BDNF 270C/T gene is not associated with susceptibility of depression, and the polymorphism of BDNF 270C/T is not correlated with the efficacy of vnlafaxine and paroxtine treatment in patients with depression.