【摘要】 目的 探讨双相障碍患者的5-羟色胺转运体基因启动子区(5-HTTLPR)基因多态性分布特征和认知功能损害的特点。方法 运用聚合酶链反应(PCR)和限制性片段长度多态性(RFLP)技术测定100例双相障碍患者(研究组)和100名健康对照者(对照组)的5-HTTLPR基因多态性。运用事件相关电位对所有被试者进行认知功能评定。运用HAMD(24项版本)、Bech-Rafaelsen躁狂量表(BRMS)分别评定双相障碍患者抑郁相、躁狂相的严重程度。结果 两组5-HTTLPR基因型频率和等位基因频率差异均无统计学意义(P>0.05);双相障碍患者躁狂相BRMS评分与事件相关电位P3潜伏期呈正相关(r=0.321,P<0.01),而抑郁相HAMD评分与事件相关电位N1、P2、N2、P3潜伏期及波幅呈正相关(r=0.637、0.379、0.472、0.572、0.433,P<0.05);双相障碍患者中携带LL基因型较SS基因型更容易患躁狂相(OR=2.471,P<0.05);无序多分类Logistic回归模型综合分析,只有躁狂相P3波幅进入回归方程(P=0.033),余变量均未进入。结论 5-HTTLPR基因多态性与双相障碍的发病及事件相关电位无相关性,双相障碍患者均存在认知功能损害,其中抑郁相认知功能损害较为显著,双相障碍患者中携带LL基因型较SS基因型可能更容易患躁狂相。更多还原

【Abstract】 Objective To investigate the correlation between the polymorphism of 5-HTT gene-linked polymorphic region(5-HTTLPR) gene and cognitive impairment in the patients with bipolar disorder(BPD).Methods The technique of polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)was applied to identify the genotypes for the polymophism of 5-HTTLPR gene in 100 patients with BPD and 100 healthy subjects. We assessed cognitive function of the subjects by event related potentia(ERP). Hamilton Rating Scale for Depression(HAMD) and Bech-Rafaelsen Mania Rating Scale(BRMS) were respectively used to determine the severity of depressive and manic phase for the BPD patients. Results The frequency of 5-HTTLPR genotypes and allelic gene were mot significantly different between BPD patients and healthy subjects(P >0.05). The BRMS scores of manic phase were significantly associated with the latency of ERP P3(r=0.321,P<0.01). The HAMD scores of depressive phase were significantly associated with the latency and amplitude of ERP Nl, ERP N2, ERP N3 and ERP P3(r=0.637, 0.379, 0.472, 0.572, 0.433; P<0.05). Compared to patients with SS genotype, patients carrying LL gneotype were tend to have manic phase(OR=2.471, P < 0.05).The comprehensive analysis of disordered multi classification Logistic regression models showed that only the P3 amplitude of manic phase entered the regression equation(P=0.033),and the remaining variables did not enter.Conclusions The polymophism of 5-HTTLPR gene is not associated with BPD risk and ERP. Impairment of cognitive function occurs in all patients with bipolar disorder. The patients with depressive phase have more damage of cognitive function, and compared to SS genotype, the BPD patients carrying LL genotype are inclined to get manic phase.更多还原