帕金森病伴发抑郁患者血浆谷氨酸和γ-氨基丁酸水平的改变及其临床意义

The plasma levels of glutamate and γ-aminobutyric acid in Parkinson's disease patients with depression and their clinical significance

目的探讨帕金森病伴发抑郁(Parkinson disease with depression,PDD)患者血浆谷氨酸(glutamate,Glu)和γ-氨基丁酸(γ-aminobutyric acid,GABA)水平的改变及其临床意义。方法采用高效液相色谱-荧光检测法(high performance liquid chromatography,HPLC-RF)检测88例PD患者,其中43例PDD患者,45例非PDD患者,以及68例健康对照者(对照组)血浆Glu、GABA水平,运用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)对所有研究对象进行评估。比较各组血浆Glu、GABA水平的差异,并对血浆氨基酸神经递质水平与HAMD评分进行相关性分析。结果 PD患者血浆Glu、GABA水平(49.81±22.79,249.17±62.57)较正常对照组(149.59±50.08,276.66±85.43)均显著降低(均P<0.05),并且PDD组血浆Glu、GABA水平(40.34±15.77,233.63±53.56)分别显著低于非PDD组(58.86±24.87,264.02±67.39)及对照组(均P<0.05)。相关性分析提示HAMD评分与血浆Glu水平(r=-0.366,P=0.000)及血浆GABA水平(r=-0.217,P=0.043)呈显著负相关。结论 PD患者血浆Glu、GABA水平的下降可能与PDD的发病有关。

ObjectiveTo investigate the plasma levels of glutamate（Glu） and γ-aminobutyric acid（GABA） in Parkinson’s disease patients with depression（PDD） and their clinical significance.MethodsPlasma levels of Glu and GABA were measured in 88 PD patients including 43 PDD patients and 45 PD patients without depression, and 68 healthy controls by using high performance liquid chromatography（HPLC-RF）. Depression was assessed in enrolled subjects by using the Hamilton Depression Scale（HAMD）. The plasma levels of Glu and GABA were compared among different groups and their associations with HAMD scores were subsequently evaluated by correlation analysis.ResultsThe plasma levels of Glu and GABA were significantly lower in PD group（49.81±22.79,249.17±62.57）than in normal control group（149.59±50.08,276.66±85.43）（all P〈0.05）. In addition, PD patients with depression exhibited significantly lower plasma levels of Glu and GABA（40.34±15.77 and 233.63±53.56）compared to PD patients without depression（58.86±24.87 and 264.02±67.39）and healthy controls（all P〈0.05）. Correlation analysis indicated that HAMD scores were negatively associated with plasma levels of Glu（ r =-0.366,P= 0.000） and GABA（ r=-0.217,P = 0.043）.Conclusion The decrease in plasma levels of Glu and GABA may be implicated in the pathogenesis of depression in PD patients.