【摘要】 目的 研究慢性乙型肝炎(CHB)患者在疾病进展的不同阶段并发抑郁症的程度以及血清脑源性神经营养因子(BDNF)的水平。方法 选择HBV病毒携带者(ASC组)、肝硬化(LC组)和肝癌(HCC组)不同病程的患者126例和40例正常对照为研究对象,采用调查问卷调查研究对象人口学资料,以汉密尔顿抑郁量表(HAMD-17)进行评分和抑郁分级,同时采用ELISA法检测血清BDNF水平。结果 LC组、HCC组离异或丧偶的比率高于对照组(X~2=6.354,11.972;P值均<0.01);ASC组、LC组、HCC组抑郁严重程度的分布均高于对照组,差异有统计学意义(X~2=16.151,42.150,49.636;P值均<0.01);同时,ASC组抑郁严重程度低于LC组和HCC组,差异有统计学意义(X~2=14.345,28.772;P值均<0.01);ASC,LC,HCC和对照组BDNF(x±s,ng/ml),分别为11.10±3.26,8.66±3.11,7.39±2.52和12.18±2.59,LC组和HCC组血清BDNF水平显著低于ASC组和对照组,差异有统计学意义(P值均<0.01);CHB病程的进展与HAMD评分存在正相关关系(r=0.719,P<0.01),与BDNF水平存在负相关关系(r=-0.504,P<0.01);血清BDNF水平与HAMD评分存在负相关关系(r=-0.526,P<0.01)。结论 CHB疾病的进程可使抑郁的程度加重,BDNF水平逐渐降低。提示血清BDNF水平可作为CHB患者心理治疗的实验室参考依据。有望提高临床医生对CHB患者伴随抑郁症发生的识别,提高诊疗效果。更多还原

【Abstract】 Objective To study the relationship of the processes of chronic hepatitis B infection with the degree of depression and the level of serum Brain-derived neurotrophic factor(BDNF).Methods 126 patients with different processes of CHB infection were divided into 3 groups,which were asymptomatic HBV carriers(ASC group),liver cirrhosis(LC group) and hepatic cell carcinoma(HCC group).40 healthy volunteers were selected as normal control.Questionnaire was used to study demographic data and the degree of depression was assessed by using Hamilton Depression Rating Scale(HAMD-17).The levels of the serum BDNF were detected by ELISA.Results The ratio of divorced or widowed in LC and HCC groups was higher than that of the control(X~2 =6.354,11.972;P<0.01).Severity of depression in ASCLC and HCC groups was higher than that of the control(X~2 =16.151,42.150,49.636;P<0.01).Severity of depression in ASC and LC group was lower than that of HCC group(X~2 =14.345,28.772>P<0.01).The role of BDNF(x±s,ng/ml) in ASCLC,HCC and control group were 11.10±3.26,8.66±3.11,7.39±2.52 and 12.18±2.59.The levels of serum BDNF in LC and HCC group was lower than ASC group and the control(P<0.01).The process of CHB infection had positive correlation with the score of HAMD(r=0.719,P<0.01),but had negative correlation with thelevels of serum BDNF(r=—0.504,P<0.01).There was negative correlation relationship between the score of HAMD and the levels of serum BDNF(r=—0.526,P<0.01).Conclusion The process of CHB infection can obviously aggravate the degree of depression,and reduce the levels of BDNF gradually.The levels of serum BDNF can be suggested as a psychological laboratory reference basis for the CHB patients with depression.It is expected to improve the level of clinical diagnosis and treatment in CHB with depression.更多还原