躯体形式疼痛障碍和伴疼痛抑郁障碍的症状学和血清脑源性神经营养因子水平比较研究

Differences in symptomatology and serum BDNF levels between persist somatoform pain disorder and depression disorder with pain symptoms

目的研究躯体形式疼痛障碍(PSPD)和伴躯体疼痛抑郁障碍(DDPS)的血清脑源性神经营养因子(BDNF)水平和临床症状,探索PSPD和DDPS之间生化机制和症状上的交叉和差异现象。方法收集PSPD患者(PSPD组)和伴躯体疼痛的抑郁障碍患者(DDPS组)进行血清采集、疼痛评分和量表评定,用ELISA法测其血清BDNF浓度。结果 BDNF血清浓度DDPS组(M=11.86 ng/ml)显著低于PSPD组(M=13.62 ng/ml)(t=-2.655,P=0.008);疼痛视觉模拟评分DDPS组[(4.88±1.17)分]低于PSPD组[(6.29±1.41)分](t=-2.769,P=0.007),贝克量表抑郁评分DDPS组[(18.79±7.21)分]高于PSPD组[(14.57±6.12)分](t=2.457,P=0.022),焦虑评分DDPS组[(36.53±9.83)分]低于PSPD组[(39.81±10.44)分](t=-2.168,P=0.031),差异均有显著性;相关关系上,疼痛视觉模拟评分与PSPD组BDNF负相关(r=-0.336,P=0.039),与PSPD组BDI分呈正相关(r=0.357,P=0.024)。结论躯体形式疼痛障碍与伴躯体疼痛的抑郁障碍的核心症状不同,生化病理机制也存在一定的差异。

Objective To explore the potential differences in symptoms and biochemistry mechanism between PSPD and DDPS by comparing the serum brain-derived neurotrophic factor（ BDNF） levels and clinical symptoms between patients with Persist Somatoform Pain Disorder （ PSPD ） and those with Depression Disorder with pain symptoms （ DDPS） . Method A total of 33 patients with PSPD and 38 patients with DDPS were recruited. These patients were assessed by Visual Analogue Scale （ VAS） , Beck Depression Inventory （ BDI） and Beck Anxiety Inventory （ BAI） . Their serum BDNF was determined by Enzyme Linked-Immuno-Sorbent Assay （ ELISA） . Result The scores of VAS [（6. 29±1. 41）score vs. （4. 88±1. 17）score, t=-2. 769,P=0. 007],BAI[（39. 81±10. 44）score vs. （36. 53± 9. 83）score,t=-2. 168,P=0. 031] were significantly higher in PSPD group than those in DDPS group; and the same as on . the serum BDNF level[（M=13. 62 ng/ml） vs. （M=11. 86 ng/ml）, t=-2. 655,P=0. 008],while the BDI score [（14. 57±6. 12）score vs. （18. 79±7. 21）score, t=2. 457,P=0. 022]was lower in PSPD group than that in DDPS group. Significant correlations between VAS score, and serum level of BDNF, and BDI score were found in PSPD group （r=-0. 336,P=0. 039;r=0. 357,P=0. 024, respectively）. Conclusion The core symptoms and disease occurrence mechanism were possibly different between PSPD and DDPS.