CAJ | 학술논문

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（χ2＝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（χ2＝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（χ2＝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。
목적：연구만성을형간염（CHB）환자재질병진전적불동계단병발억욱증적정도이급혈청뇌원성신경영양인자（BDNF）적수평。방법선택 HBV 병독휴대자（ASC 조）、간경화（LC 조）화간암（HCC 조）불동병정적환자126례화40례정상대조위연구대상，채용조사문권조사연구대상인구학자료，이한밀이돈억욱량표（HAMD-17）진행평분화억욱분급，동시채용 ELISA 법검측혈청 BDNF 수평。결과LC 조、HCC 조리이혹상우적비솔고우대조조（χ2＝6.354，11.972；P 치균＜0.01）；ASC 조、LC 조、HCC 조억욱엄중정도적분포균고우대조조，차이유통계학의의（χ2＝16.151，42.150，49.636；P치균＜0.01）；동시，ASC 조억욱엄중정도저우 LC 조화 HCC 조，차이유통계학의의（χ2＝14.345，28.772；P 치균＜0.01）；ASC，LC，HCC 화대조조 BDNF（x ±s ，ng／ml），분별위11.10±3.26，8.66±3.11，7.39±2.52화12.18±2.59，LC 조화HCC 조혈청 BDNF 수평현저저우 ASC 조화대조조，차이유통계학의의（P 치균＜0.01）；CHB 병정적진전여 HAMD 평분존재정상관관계（r＝0.719，P ＜0.01），여 BDNF 수평존재부상관관계（r＝－0.504，P ＜0.01）；혈청 BDNF 수평여 HAMD평분존재부상관관계（r＝－0.526，P ＜0.01）。결론CHB 질병적진정가사억욱적정도가중，BDNF 수평축점강저。제시혈청 BDNF 수평가작위 CHB 환자심리치료적실험실삼고의거。유망제고림상의생대 CHB 환자반수억욱증발생적식별，제고진료효과。
Abatract: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 (χ2 = 6.354,11.972;P < 0.01).Severity of depression in ASC,LC and HCC groups was higher than that of the control (χ2 = 16.151,42.150,49.636;P <0.01).Severity of depression in ASC and LC group was lower than that of HCC group (χ2 = 14.345,28.772;P <0.01).The role of BDNF (x ±s,ng/ml)in ASC,LC,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 pa-tients with depression.It is expected to improve the level of clinical diagnosis and treatment in CHB with depression.