摘要
目的分析抑郁症病人自杀意念、行为的危险因素。方法选取商丘市第二人民医院2020年1月至2021年8月185例抑郁症初诊病人(研究组),采用倾向值匹配法另选取185例健康志愿者(对照组)。采用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)检测两组脑源性神经营养因子(BDNF)基因多态性并比较;分别采用自杀意念自评量表(SIOSS)和专家访谈方式调查研究组的自杀意念、行为,采用logistic多元回归法分析自杀意念、行为的影响因素。结果两组BDNF第66个氨基酸处的缬氨酸突变为蛋氨酸(Val66Met)基因型分布与等位基因频率比较差异无统计学意义(P>0.05),且均符合遗传平衡规律(P>0.05);研究组离婚/丧偶病人SIOSS评分高于未婚、已婚[(12.86±3.05)分比(8.73±1.98)分、(10.02±2.01)分](P<0.05),无业病人SIOSS评分高于在编人员、普通职员/个体户[(13.63±3.04)分比(8.04±1.95)分、(9.78±2.04)分](P<0.05),收入水平<3000元/月SIOSS评分高于3000~5000、>5000元/月[(13.12±3.08)分比(9.45±1.76)分、(8.10±1.52)分](P<0.05),独居、无家庭支持、无社会支持SIOSS评分均高于非独居、有家庭支持、有社会支持[(19.22±3.36)分比(8.12±1.88)分、(9.10±2.14)分比(14.09±2.35)分、(9.25±2.08)分比(12.17±2.44)分](P<0.05),BDNF Val66Met GG基因型SIOSS评分高于AA、AG基因型[(11.29±2.50)分比(7.65±1.77)分、(10.02±2.48)分](P<0.05);研究组有自杀意念占比44.32%(82/185),离婚/丧偶、无业、<3000元/月、独居、无家庭支持、无社会支持、BDNF Val66Met GG基因型均是研究组有自杀意念的危险因素(OR=4.13、4.74、7.19、6.06、4.66、4.75、7.48,P<0.05);研究组有自杀行为占比17.84%(33/185),<3000元/月、无家庭支持、BDNF Val66Met GG基因型均是研究组有自杀行为的危险因素(OR=5.05、3.41、6.72,P<0.05)。结论BDNF Val66Met GG基因型与抑郁症病人自杀意念、行为均有关。
Objective To analyze the risk factors for suicidal ideation and behavior in patients with depression.Methods A total of 185 patients with depression initially diagnosed in the Second People´s Hospital of Shangqiu City from January 2020 to August 2021 were selected(study group),and another 185 healthy volunteers were selected by propensity value matching(control group).Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)was used to detect polymorphisms of the brain-derived neurotrophic factor(BDNF)gene in the two groups and compared them.Suicidal ideation and behavior of the study groups were investigated by using the Self-rating Idea of Suicide Scale(SIOSS)and expert interviews,respectively,and the influencing factors of suicidal ideation and behavior were analyzed by the logistic multiple regression method.Results There were no significant differences in the genotype distribution and allele frequency of valine mutated to methionine(Val66Met)at amino acid 66 of BDNF between the two groups(P>0.05),and all of them were in accordance with the law of genetic equilibrium(P>0.05).The SIOSS score of divorced/widowed patients in the study group was higher than that of unmarried and married patients[(12.86±3.05)scores vs.(8.73±1.98)scores,(10.02±2.01)scores](P<0.05).The SIOSS score of unemployed patients was higher than that of the workforce,ordinary employees/self-employed[(13.63±3.04)scores vs.(8.04±1.95)scores,(9.78±2.04)scores](P<0.05).The SIOSS scores were higher(P<0.05)for income level<3000 yuan/month than for 3000 to 5000 and>5000 yuan/month[(13.12±3.08)score vs.(9.45±1.76)score,(8.10±1.52)score],and the SIOSS scores were higher(P<0.05)for living alone,without family support,and without social support than for not liv-ing alone,with family support,and with social support[(19.22±3.36)points vs.(8.12±1.88)points,(9.10±2.14)points vs.(14.09±2.35)points,and(9.25±2.08)points vs.(12.17±2.44)points](P<0.05).The SIOSS score of the BDNF Val66Met GG genotype was higher than that of the
作者
冯连启
刘杰
王娟
FENG Lianqi;LIU Jie;WANG Juan(No.10 Ward,Department of Psychiatry,Shangqiu Second People's Hospital,Shangqiu,He'nan 476000,China)
出处
《安徽医药》
CAS
2024年第1期84-89,共6页
Anhui Medical and Pharmaceutical Journal
关键词
抑郁症
自杀意念
自杀
脑源性神经营养因子
基因多态性
危险因素
Depressive disorder
Suicidal ideation
Suicide
Brain-derived neurotrophic factor
Gene polymorphisms
Risk factors
