复发性抑郁症患者治疗前后血管内皮生长因子水平变化及与临床疗效的相关性

Serum VEGF levels in relation to clinical features and therapeutic effect of patients with recurrent depression

目的探讨复发性抑郁症患者血管内皮生长因子(VEGF)水平与临床特征及疗效的关系。方法对59例复发性抑郁症患者(抑郁症组)给予抗抑郁药物(SSRIs)治疗并随访8周;采用酶联免疫吸附法(ELISA),测定抑郁症组治疗前后第4、8周及60例正常人(健康对照组)的血清VEGF水平,采用汉密尔顿抑郁量表(HAMD)减分率评定疗效。结果家族史阳性、伴有自杀行为的患者VEGF水平偏低(P=0.001、0.026);抑郁症组血清VEGF水平较健康对照组高(P=0.038),用药后有升高趋势,第8周时血清VEGF水平与治疗前比较差异有统计学意义(P=0.01 1);第4、8周HAMD总分逐渐降低并均明显低于治疗前(均P=0.001);第4周血清VEGF增加率和HAMD减分率无关(P=0.839),第8周血清VEGF增加率和HAMD减分率呈正相关(P=0.032)。结论复发性抑郁症患者血清VEGF水平高于健康对照组,治疗前后VEGF水平变化尚不能作为评价疗效的特异性指标。

Objective To investigate serum VEGF levels in relation to clinical features and therapeutic effect in patients with recurrent depression （RD）. Methods Fifty nine RD patients and 60 healthy individuals were included in the study. The patients were treated with selective serotonin reuptake inhibitors （SSRIs）. Serum VEGF levels were measured by ELISA and the severity of depression was evaluated with HAMD before （W0） and 4 （W4）, 8 （W8） weeks after treatment. HAMD reductive ratio was used to assess the clinical effect. Results Serum VEGF levels in RD patients with suicidal behavior was significantly lower than those in patients without suicidal behavior （P=0.026）; Serum VEGF levels in patients with family history was significantly lower than those without family history （P=0.001）. Before treatment the serum VEGF levels in RD patients were significantly higher than those in controls （P=-0.038）; the VEGF level raised gradually with the drug therapy and elevated significantly at week 8 after treatment （P=0.011）. The HAMD scores at W4 and W8 declined significantly compared with W0 （P=0.001）. No correlation was observed between VEGF increasing ratio and HAMD deductive ratio at W4 （P=0.839）; however, VEGF increasing ratio was correlative with HAMD deductive ratio significantly at W8 （P=0.032）. Conclusion Serum VEGF level is increased in RD patients, however, its variation is not closely correlated with therapeutic effect.