摘要
目的探讨重性抑郁障碍患者中,节律相关基因CRY2 rs10838524位点及ARNTL rs2278749位点多态性与选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitors,SSRIs)疗效、副反应及患者临床症状的关联性。方法采用聚合酶链式反应(polymerase chain reaction,PCR)和PCR产物直接测序法对537例中国汉族重性抑郁障碍患者CRY2 及ARNTL基因进行分型。其中319例患者完成6周SSRIs抗抑郁治疗。在基线期及治疗2、4、6周末用17项汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD17)及不良反应量表(treatment emergent symptom scale/ UKU side effect rating scale,TESS/UKU)评估抑郁严重程度和副反应情况,以6周末HAMD17减分率评估疗效。结果未发现治疗有效组与无效组间CRY2 rs10838524位点及ARNTL rs2278749位点基因型分布差异具有统计学意义(P>0.05);未发现不同基因型患者治疗前HAMD17各因子分值的差异具有统计学意义(P>0.05);ARNTL基因rs2278749位点CT+TT基因型患者相对于CC基因型更易发生腹泻(P=0.030, OR=1.91, 95%CI:1.06~3.45)及头晕(P=0.038, OR=1.55, 95%CI:1.02~2.35)副反应。结论本研究未发现节律相关基因CRY2 rs10838524位点及ARNTL rs2278749位点多态性与中国汉族重性抑郁障碍患者SSRIs疗效及临床症状有关,但ARNTL rs2278749位点多态性可能与SSRIs治疗过程出现腹泻及头晕副反应有关。
Objective To explore the relationship between polymorphisms of CRY2 rs10838524 and ARNTL rs2278749 and the efficacy and adverse effects of SSRIs on Major Depressive Disorder (MDD) as well as clinical symptoms of MDD. Methods This study enrolled a total of 537 patients, who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) diagnostic criteria for MDD. Three hundred nineteen patients completed 6 weeks of SSRIs antidepressant treatment. The 17-item Hamilton depression scale (HAMD17) and the treatment emergent symptom scale/ the UKU side effect rating scale (TESS/UKU) were used to assess the efficacy of antidepressants and adverse effects. PCR and DNA sequencing analysis were used to genotype loci of CRY2 and ARNTL genes. Results No significant difference was found in the distribution of CRY2 and ARNTL SNPs genotypes between the effective group and the ineffective group (P>0.05). No significant difference in clinical symptom factor scores was found among patients with different genotypes (P>0.05). Significant differences were observed that patients with ARNTL rs2278749 CT+TT genotypes were more prone to diarrhea (P=0.030, OR=1.91, 95%CI: 1.06~3.45) and dizziness (P=0.038, OR=1.55, 95%CI: 1.02~2.35) than those with CC genotype. Conclusion The polymorphisms of CRY2 rs10838524 and ARNTL rs2278749 may have no relationship with the efficacy of SSRIs and clinical symptoms in Chinese Han patients with MDD, and the polymorphisms of ARNTL rs2278749 may have relationship with diarrhea and dizziness adverse effects during the treatment of SSRIs.
作者
马惠莹
徐一凡
刘志芬
胡晓东
孙宁
李忻蓉
王彦芳
张克让
MA Huiying;XU Yifan;LIU Zhifen;Hu Xiaodong;SUN Ning;LI Xinrong;ZHANG Kerang(Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2019年第5期293-298,共6页
Chinese Journal of Nervous and Mental Diseases
关键词
重性抑郁障碍
生物节律
基因多态性
抗抑郁疗效
Major Depressive Disorders
Circadian rhythm
Gene polymorphisms
Antidepressant treatment
