青年血液透析患者BDNF及GDNF水平与精神心理状态相关性分析

Correlation analysis of BDNF,GDNF and quality of life in young patients accepting maintenance hemodialysis

目的研究青年血液透析患者脑源性神经营养因子(brain derived neurotrophic factor,BDNF)及胶质细胞源性生长因子(glial cell-derived neurotrophic factor,GDNF)水平与精神心理状态的相关性。方法选择到西安市第四医院接受维持性血液透析的青年患者97例为观察组,同时选择50名健康人群作为对照组,分别采用症状自评量表(symptom check list-90,SCL-90)量表评估入选者精神心理状态,采用酶联免疫法(enzyme linked immunosorbent assay,ELISA)法测定血清BDNF及GDNF水平,分析精神心理状态与BDNF及GDNF相关性。结果观察组患者量表中躯体化、强迫、抑郁、焦虑、敌对评分较常模及对照组有统计学差异(P<0.05),人际关系、恐怖、偏执、精神病性评分较常模及对照组虽有升高但未见统计学差异(P>0.05)。观察组患者BDNF及GDNF水平较对照组均有显著性下降(P<0.05),其中男性患者及女性患者BDNF与GDNF均较对照组有显著性下降(P<0.05);比较观察组内男性患者及女性患者BDNF及GDNF水平,两组未见统计学差异(P>0.05)。相关性分析表明SCL-90评分中躯体化、敌对与BDNF未见显著相关性(r=-0.028、-0.047,P>0.05),强迫、抑郁、焦虑与BDNF均有显著相关性(r=-0.317、-0.294、-0.309,P<0.05)。躯体化、敌对与GDNF未见显著相关性(r=-0.079、0.021,P>0.05),强迫、抑郁、焦虑与GDNF均有显著相关性(r=-0.395、-0.317、-0.374,P<0.05)。结论接受维持性血液透析的青年患者多存在焦虑、抑郁等精神心理障碍及BDNF、GDNF水平下降,BNDF及GDNF水平下降可能是精神心理障碍发生的重要机制。

Objective To analyze the correlation of psychological status, brain derived neurotrophic factor （BDNF） and glial cell-derived neurotrophic factor （GDNF） levels in young patients accepting maintenance hemodialysis. Methods Ninety-seven cases of young patients accepting maintenance hemodialysis were selected as the observation group, while 50 cases of healthy people were chosen as the control group. The symptom check list-90 （SCL-90） was used to assess mental and psychological state. BDNF and GDNF were tested using ELISA. The relationship between psychological state and BDNF, GDNF was also analyzed. Results Somatization, dePression, anxiety, and hostility scores in the observation group were significantly increased as compared with the norm and those in the control group （P〈0. 05）. There was no significant difference in interpersonal relationships, terror, paranoid, and psychotic scores between the observation group with the norm and the control group （P〉0. 05）. GDNF and BDNF in the observation group were significantly decreased as compared with the control group （P〈0. 05）. There was no significant difference between male and female patients in the observation group （P〉0. 05）. Correlation analysis showed that somatization and hostility in SCL-90 scores showed no significant negative correlation with BDNF （r = - 0. 028, - 0. 047, P〉0. 05）, and obsessive-compressive, anxiety and depression showed significant correlation with BDNF （r = -0. 317, - 0. 294, - 0. 309, P〈0. 05）. Somatization and hostility in SCL-90 scores showed no significant negative correlation with GDNF （r = - 0. 079,0. 021, P〉0. 05）, and obsessive-compressive, anxiety and depression showed significant correlation with GDNF （r = - 0. 395, -0. 317, - 0. 374, P〈0. 05）. Conclusions Psychological status in young patients accepting maintenance hemodialysis showed decreased BDNF and GDNF as well as psychological disorders sach as anxiety, depression, etc. The decreases in GDNF and BDNF may contribute to psychological disorder.