首发性抑郁症患者血清GFAP、NSE、Hcy水平与认知功能的关系

Relationship between serum GFAP,NSE,Hcy levels and cognitive function in patients with first-episode depression

目的探讨首发性抑郁症患者血清胶质纤维蛋白(GFAP)、神经特异性烯醇化酶(NSE)、同型半胱氨酸(Hcy)水平与认知功能的关系。方法选取2015年6月至2016年6月延安大学咸阳医院精神科收治的40例首发性抑郁症患者(抑郁症组)和40例健康体检者(健康对照组)作为研究对象,采用酶联免疫吸附试验测定两组研究对象血清GFAP、NSE、Hcy水平,采用韦氏成人智力测验量表第四版(WAIS-Ⅳ)、韦氏记忆测验第四版(WMS-Ⅳ)、威斯康星卡片分类测验(WCST)对两组研究对象认知功能进行评定,采用汉密尔顿抑郁量表(HAMD)对抑郁患者病情严重程度进行评价,采用Pearson单因素分析血清GFAP、NSE、Hcy与认知功能及病情的关系。结果抑郁症组患者血清GFAP、NSE、Hcy水平明显高于健康对照组,差异有统计学意义(P<0.05);抑郁症组WAIS-Ⅳ各维度评分及总评分、WMS-Ⅳ各维度评分及总评分均低于健康对照组,差异均有统计学意义(P<0.05);抑郁症组WCST总测验数、持续错误数、随机错误数明显高于健康对照组,差异均有统计学意义(P<0.05)。经Pearson单因素分析,GFAP与WAIS-Ⅳ总评分及其工作记忆指数、认知效率指数、WMS-Ⅳ总评分及其即时记忆评分均呈负相关,而与WCST总测验数呈正相关(P<0.05),血清NSE、Hcy均与WAIS-Ⅳ总评分及其纬度中的知觉推理指数、工作记忆指数、认知效率指数、WMS-Ⅳ总评分呈负相关(P<0.05),血清GFAP、NSE、Hcy与HAMD评分呈正相关(P<0.05)。结论首发性抑郁症患者存在血清GFAP、NSE、Hcy水平升高,与患者认知功能损害及抑郁病情有关。

Objective To investigate the relationship between glial fibrillary acidic protein(GFAP),neuron specific enolase(NSE),homocysteine(Hcy)and cognitive function in patients with first-episode depression.Methods The levels of GFAP,NSE and Hcy of 40 cases of patients with first-episode depression(depression group),who were treated in the hospital from June 2015 to June 2016,and 40 cases of healthy people(healthy control group)were measured by ELSA.The cognitive functions of two groups were evaluated with Wechsler Adult Intelligence Test Scale Fourth Edition(WAIS-Ⅳ),Wechsler Memory Test Fourth Edition(WMS-IV),Wisconsin Card Sorting Test(WCST).The severity of depression in patients were assessed with Hamilton Depression Rating Scale(HAMD).The relationship between the levels of GFAP,NSE,Hcy and cognitive function and disease was analyzed by Pearson univariate analysis.Results The levels of serum GFAP,NSE and Hcy in depression group were significantly higher than those in control group(P<0.05).The scores in each dimension and the overall scores of WAIS-Ⅳand WMS-Ⅳin depression group were significantly lower than those in control group(P<0.05).The total number of WCST,the number of continuous errors and the number of random errors in depression group were significantly higher than those in the control group(P<0.05).By pearson univariate analysis,the levels of GFAP were negatively correlated with the total score of WAIS-Ⅳ,working memory index and cognitive efficiency index,the total score of WMS-Ⅳ and instant memory,but were positively correlated with the overall number of WCST test(P<0.05).The levels of NSE and Hcy were negatively correlated with the total score of WAIS-Ⅳ and the perceptual reasoning index,working memory index,cognitive efficiency index and the total score of WMS-Ⅳ(P<0.05).The levels of serum GFAP,NSE and Hcy were positively correlated with HAMD score(P<0.05).Conclusion The levels of serum GFAP,NSE and Hcy in the patients with first episode depression increase,and this is positively correlated with the cognitive impairment and depression.