康复治疗阶段慢阻肺合并焦虑抑郁患者脑源性神经营养因子和血管活性肠肽的表达分析

Expression of brain-derived neurotrophic factor and vasoactive intestinal peptide in patients with chronic obstructive pulmonary disease complicated with anxiety and depression during rehabilitation

目的分析康复治疗阶段慢阻肺合并焦虑抑郁患者脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)和血管活性肠肽(vasoactive intestinal peptide,VIP)的表达水平及其临床意义。方法收集68例康复治疗阶段慢阻肺合并焦虑抑郁患者作为观察组,均采取抗抑郁药帕罗西汀进行治疗,另选同期的68例单纯康复治疗阶段慢阻肺患者作为对照组,采用焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-Rating Depression Scale,SDS)测量治疗前后的焦虑抑郁程度,使用酶联免疫吸附实验法(ELISA)检测观察组患者及对照组健康体检者BDNF、VIP的表达水平,并分析BDNF、VIP与SAS、SDS评分的相关性。结果治疗前,观察组患者SAS、SDS评分均高于对照组,差异显著(P<0.05);治疗后,观察组患者SAS、SDS评分较治疗前显著下降,差异显著(P<0.05),且与对照组比较,差异不显著(P>0.05);治疗前,观察组患者BDNF表达水平低于对照组,VIP表达水平高于对照组,差异显著(P<0.05);治疗后,观察组患者BDNF表达水平较治疗前升高,VIP表达水平较治疗前降低,差异显著(P<0.05),但BDNF表达水平仍低于对照组,VIP表达水平仍高于对照组,差异显著(P<0.05);经Pearson相关分析,SAS、SDS评分均与BDNF表达水平呈负相关,VIP表达水平呈正相关(P<0.05)。结论 BDNF、VIP可作为康复治疗阶段慢阻肺合并焦虑抑郁的生物学观察指标,检测BDNF、VIP表达水平,对于判断病情的严重程度、评估疗效及预后均具有积极作用。

Objective To analyze the expression level of brain-derived neurotrophic factor( BDNF) and vasoactive intestinal peptide( VIP) in COPD patients complicated with anxiety and depression at the stage of rehabilitation therapy and its clinical significance. Methods 68 COPD patients complicated with anxiety and depression were enrolled in this study,and another 68 healthy subjects were selected as the control group. The self-rating anxiety scale( SAS),self-rating depression scale( SDS) were used to measure the degree of anxiety and depression before and after treatment. The levels of BDNF and VIP were examined by enzyme-linked immunosorbent assay( ELISA),and their correlation with SAS and SDS score were analyzed. Results Before and after treatment,the SAS and SDS scores of the observation group were significantly higher than those of the control group( P < 0. 05). After treatment,the scores of SAS and SDS in the observation group were significantly lower than those before treatment( P < 0. 05).After treatment,the expression of BDNF in the observation group was lower than that in the control group,and the level of VIP expression was significantly higher than that in the control group( P < 0. 05). After treatment,the expression of BDNF was significantly higher( P < 0. 05),but the expression of BDNF was lower in the observation group than in the control group( P < 0. 05). Pearson correlation analysis showed that SAS and SDS scores were negatively correlated with BDNF expression and positively correlated with VIP expression( P < 0. 05). Conclusion BDNF and VIP can be used as biological indicators of chronic obstructive pulmonary disease( COPD) combined with anxiety and depression. The expression of BDNF and VIP can be used to judge the severity of the disease,and to evaluate the curative effect and prognosis.