首发抑郁症患者血清成纤维细胞生长因子22、胶质纤维酸性蛋白水平及其临床意义

Levels of Serum Fibroblast Growth Factor-22 and Glial Fibrillary Acidic Protein in Patients with First-episode Depression and Its Clinical Significance

目的:检测首发抑郁症患者血清中成纤维细胞生长因子22(FGF-22)和胶质纤维酸性蛋白(GFAP)水平,并探讨其临床意义。方法:选取2018年2月至2019年2月我院就诊并住院的首发抑郁症患者40例(抑郁症组)和体检中心的健康体检人员40例(健康对照组)作为研究对象,采用酶联免疫吸附试验检测研究对象血清中的FGF-22和GFAP水平,采用汉密尔顿抑郁量表(HAMD-17)评价研究对象的抑郁症状,采用威斯康星卡片分类测验(WCST)测试研究对象的执行功能,采用Pearson积矩相关系数分析血清FGF-22和GFAP水平与HAMD-17评分及执行功能的关系,采用受试者工作特征(ROC)曲线评估FGF-22、GFAP的诊断价值。结果:抑郁症组患者血清GFAP水平、HAMD-17评分、WCST持续错误数和随机错误数显著高于健康对照组(P<0.05),血清FGF-22水平、WCST正确应答数和完成分类数显著低于健康对照组(P<0.05)。抑郁症组患者血清FGF-22浓度与WCST正确应答数和完成分类数呈正相关(P<0.05),与HAMD-17评分、WCST持续错误数和随机错误数呈负相关(P<0.05);抑郁症组患者血清GFAP水平与WCST正确应答数和完成分类数呈负相关(P<0.05),与HAMD-17评分、WCST持续错误数和随机错误数呈正相关(P<0.05)。ROC曲线分析显示,FGF-22诊断首发抑郁症的最佳界点为194.3 ng/mL,诊断灵敏度和特异度分别为87.5%和72.5%,ROC曲线下面积(AUC)为0.848(95%的置信区间为0.755-0.941);GFAP诊断首发抑郁症的最佳界点为1128 ng/L,诊断敏感度和特异度分别为80.0%和85.0%,AUC为0.866(95%的置信区间为0.785-0.948)。结论:首发抑郁症患者血清FGF-22和GFAP水平与患者抑郁严重程度和执行功能损害有关。

Objective: To measured the levels of serum fibroblast growth factor-22(FGF-22) and glial fibrillary acidic protein(GFAP) in patients with first-episode depression, and to explore its clinical significance. Methods: From February 2018 to February 2019,40 first-episode depression patients(depression group) treated in our hospital and 40 health checkers(health control group) in the physical examination center were selected as the study objects. The levels of FGF-22 and GFAP in the serum of the subjects were detected by enzyme-linked immunosorbent assay. The Hamilton Depression Scale(HAMD-17) was used to evaluate the severity of depression. The Wsiconsin Card Sorting Test(WCST) was used to test the performing function. We used Pearson product-moment correlation to evaluate the relationship between serum FGF-22, GFAP levels and HAMD-17 scores and performing function. The diagnostic value of the two factors was evaluated by receiver operating characteristic(ROC) curve. Results: Serum GFAP levels, HAMD-17 scores, WCST perseverative errors and random errors in the depression group were significantly higher than the healthy control group(P<0.05). Serum FGF-22 levels, WCST correct response, and categories completed in the depression group were significant lower than the healthy control group(P<0.05). The serum FGF-22 concentration in the depression group was positively correlated with the correct responses and the categories completed(P<0.05), and negatively correlated with HAMD-17 scores, WCST perseverative errors, and random errors(P<0.05);The GFAP level in the depression group was negatively correlated with the WCST correct responses and the categories completed(P<0.05),and positively correlated with HAMD-17 scores, WCST perseverative errors, and random errors(P<0.05). ROC curve analysis display,the best borderline of FGF-22 in the diagnosis of first-episode depression was 194.3 ng/ml. the sensitivity and specificity of FGF-22 were87.5% and 72.5% respectively, the area under curve was 0.848(95%CI 0.755-0. 941). The best borderline of GFAP in the diagnosis of first-episode depression was 1128 ng/L, the sensitivity and specificity were 80.0% and 85.0% respectively, and the area under curve was0.866(95%CI 0.785-0.948). Conclusion: Serum FGF-22 and GFAP levels in patients with first-episode depression are related to the severity of depression and performing function impairment.