单相抑郁症与双相障碍抑郁相患者神经肽Y、P物质水平差异及其与抑郁严重程度的相关性分析

The difference of neuopeptide Y and substance P level between unipolar depression and bipolar depression and its correlation with depression severity

目的探讨单相抑郁症与双相障碍抑郁相(双相抑郁)患者血清神经肽Y(Neuropeptide Y,NPY)和P物质(substance P,SP)水平的差异及其与抑郁严重程度间的相关性。方法以美国精神障碍诊断与统计手册第4版(DSM-IV)为标准,自2013年7月至2015年5月共入组单相抑郁症患者39例,双相抑郁症患者38例以及健康对照组40例。签署知情同意后,以酶联免疫吸附法测定血清NPY及SP水平,并采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定受试者抑郁和焦虑症状。结果单因素方差分析显示三组间血清NPY及SP水平存在显著性差异。两两比较显示,单相抑郁症组与双相抑郁症组血清NPY水平均低于对照组[(5.87±4.16)μg/m L,(6.21±2.35)μg/m L VS.(8.36±3.32)μg/m L,P=0.04],而两组血清SP水平均高于对照组[(6.19±2.57)μg/m L,(5.63±2.51)μg/m L VS.(4.26±1.14)μg/m L,P=0.04,0.03],两组间比较发现,单相抑郁组血清SP水平高于双相抑郁组(P=0.03),两组间血清NPY水平差异无统计学意义。相关性分析发现,单项抑郁组NPY水平与HAMD得分呈负相关(r=0.61,P=0.04)。结论血清神经肽Y和P物质可能参与抑郁症的病理生理过程,检测二者的血清水平有助于判断疾病分型及病情评估。

Objective To compare differences of the serum levels of neuropeptide Y（NPY）and substance P（SP）between patients with unipolar depression and bipolar depression,and then explore the potential linkage between NPY/SP and the severity of depression. Method We recruited 39 unipolar depressive patients,38 bipolar depressive patients and 40 well-matched healthy controls（HC）in this study. The diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition（DSM-IV）criteria. The serum NPY and SP concentrations were determined by enzyme-linked immunosorbent assay. The Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）were applied to assess the severity of clinical symptoms of depression and anxiety. Results The serum NPY levels in both unipolar and bipolar depression group were lower than HC group [（5.87±4.16）μg/m L,（6.21±2.35）μg/m L VS.（8.36±3.32）μg/m L,P=0.04],while the serum levels of SP in two group were significantly higher than HC group [（6.19±2.57）μg/m L,（5.63±2.51）μg/m L VS.（4.26±1.14）μg/m L,P=0.04,0.03],the Post-Hoc comparison found that serum SP levels in unipolar depression were higher than bipolar depression group（P=0.03）,but there was no significant difference of serum NYP levels between two groups. Correlation analysis detected that the NPY level was negatively correlated with HAMD scores in unipolar depression group（r=-0.61,P=0.04）. Conclusion The NPY and SP maybe involve in the pathophysiology of depression,and the NPY and SP would be useful biomarkers to separate the subtype of depression and evaluate the severity of disease.