抑郁症患者5-羟色胺转运体启动子区基因多态性和认知功能的听觉事件相关电位的研究

Study on polymorphism of 5-hydroxytrypamine transporter gene-linked promoter region and characteristics of auditory event-related potentials in patients with depression

目的探讨抑郁症患者的5-羟色胺转运体基因启动子区(5-HTTLPR)基因多态性分布特征和认知功能的损害特点。方法运用聚合酶链反应-限制性片段长度多态(PCR-RFLP)测定60例抑郁症患者(研究组)和60例健康对照者(对照组)的5-HTTLPR基因多态性。应用汉密尔顿抑郁量表(HAMD)、威斯康星卡片分类测验(WCST)、事件相关电位P300对所有被试者进行抑郁和认知功能评定。结果两组5-HTTLPR基因型频率和等位基因频率差异均无统计学意义(P>0.05)。SS基因型患者HAMD分值明显高于LS型及LL型(P=0.003,P=0.004)。研究组WCST测评完成分类数低于对照组,持续性错误数、不能维持完整分类数高于对照组(P<0.05);研究组P300潜伏期延长、P300波幅降低(P<0.05)。研究组P300潜伏期与错误应答数呈正相关(r=0.817,P=0.034)。结论 5-HTTLPR基因多态性与抑郁症的发病无相关性,但与抑郁症的严重程度相关;抑郁症患者存在认知功能障碍,其中执行功能和注意功能的降低较为显著。

Objective To explore the polymorphism of 5-hydroxytrypamine transporter gene-linked polymorphic region （5- HTFLPR） and cognitive impairment characteristics in patients with depression. Methods 5-HTFLPR polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） in 64 patients with depression （study group） and 66 healthy controls （control group ）. Depressive patients were assessed with Hamilton Depression Scale （HAMD） to evaluate the severity of depression and were assessed with Wisconsin Card Sorting Test （WCST） and event-related potentials 19300 to evaluate the cognitive impairment. Results There were no significant differences in 5-HTFLPR genotypic frequency and allele frequencies between the two groups （ P 〉 0. 05 ）. Score of HAMD in patients with SS genotype were significantly higher than those with LS genotype （ P = 0.003 ）, and LL genotype （ P = 0.004）. Number of Re of WCST in study group was significantly lower than that in control group. Number of Rpe and Fm of WCST in study group were significantly higher than those in control group （ P 〈 0.05 ）. Compared with control group, latency of P300 was significantly longer and amplitude of P300 was significantly lower in study group （ P 〈 0.05 ）. Latency of P300 was significantly positively correlated with number of error response （r = 0. 917, P = 0.034）. Conclusion The polymorphism of 5-HTrLPR may not be associated with the etiology of depression, but might be associated with the severity of depression. Depressive patients have cognitive deficit, especially the executive impairment and attention impairment.