血清BDNF和Ghrelin水平与冠心病介入术后并发抑郁症的关系

Relationship between Serum BDNF,Ghrelin and Coronary Heart Disease after Interventional Complicated with Depression

【目的】探讨血清脑源性神经营养因子(BDNF)、胃饥饿素(Ghrelin)水平与冠心病介入术后并发抑郁症的联系。【方法】选择2015年3月至2017年2月我院心内科收治的无抑郁症的冠心病患者142例,经PCI术后,按照汉密尔顿抑郁量表(HAMD)评分标准,患者分为PCI术后合并抑郁患者(HAMD评分≥7分,抑郁组,n=45)和PCI术后无抑郁患者(HAMD评分<7分,非抑郁组,n=97)。比较两组患者PCI术治疗后3 d血清中BDNF和Ghrelin水平,同时比较不同抑郁程度患者血清中BDNF和Ghrelin水平,另外分析血清BDNF和Ghrelin水平与HAMD评分的相关性。【结果】无抑郁症的冠心病患者经PCI术后有31.7%患者并发抑郁症;且术后并发抑郁组患者血清BDNF和Ghrelin水平均显著低于非抑郁组患者(P <0.05);术后不同抑郁程度患者血清BDNF和Ghrelin水平之间的差异具有统计学意义(P <0.05),抑郁患者和严重抑郁患者血清BDNF和Ghrelin水平显著低于可能抑郁患者,同时严重抑郁患者血清BDNF和Ghrelin水平显著低于抑郁患者,且差异均具有统计学意义(P <0.05);冠心病患者PCI术后血清BDNF、Ghrelin水平与HAMD评分呈负相关(P <0.05)。BDNF、Ghrelin的ROC曲线的分析结果显示血清BDNF AUC为0.99,临界值为0.16,敏感性和特异性分别为100%和98.97%。血清Ghrelin AUC为0.93,临界值为0.25,敏感性和特异性分别为95.6%和79.4%。【结论】血清BDNF、Ghrelin水平与冠心病患者PCI术后并发抑郁症患者密切相关,可以反映抑郁症的严重程度。

【Objective】To explore the relationship between serum brain-derived neurotrophic factor(BDNF),Ghrelin and postoperative depression of coronary heart disease(CHD).【Methods】After PCI surgery,according to the Hamilton depression rating scale(HAMD)score standard,142 cases of patients with coronary heart disease from March 2015 to February 2017 were divided into primary PCI patients(HAMD score≥7 points,the depression group,n=45)and PCI postoperative patients with non-depression(H AMD score<7 points,the non-depression group,n=45).The HAMD scores of two groups of patients before 3 days and 3 days after treatment were compared,and the levels of BDNF and Ghrelin of two groups of patients 3 days after treatment were contrasted.At the same time the levels of BDNF and Ghrelin of patients with different degree of depression were compared.In addition,the correlation of serum BDNF and Ghrelin levels and HAMD scores was analyzed.【Results】Patients with coronary heart disease without depression had 31.69%of patients with depression after PCI surgery;The differences of different levels of depression in patients with postoperative serum BDNF and Ghrelin were statistically significant(P<0.05).The levels of serum BDNF and Ghrelin postoperative of depression and severe depression patients were significantly lower than patients of may be depressed.The levels of serum BDNF and Ghrelin of severe depression patients were significantly lower than patients with depression,and the differences were statistically significant(P<0.05).Serum BDNF and Ghrelin levels after PCI were negatively correlated with HAMD scores(P<0.05).The results of the analysis of the ROC curves of BDNF and Ghrelin showed that the serum BDNF AUC was 0.99,the critical value was 0.16,and the sensitivity and specificity were 100%and 98.97%,respectively.The se-rum Ghrelin AUC was 0.93,the critical value was 0.25,and the sensitivity and specificity were 95.6%and 79.4%,re-spectively.【Conclusion】Serum BDNF and Ghrelin levels are closely related to depression in the patients with coronary heart disease after PCI,which can reflect the severity of depression.