5-HTT基因多态性与SSRIs,SNRIs类抗抑郁药治疗抑郁症临床疗效的关系研究

目的研究中国人群中5-HTT基因多态性与抑郁症及SSRIs和SNRIs类药物临床疗效是否存在相关性。方法用聚合酶链式反应多态性分析(PCR)技术对148例抑郁症患者和100例健康者进行基因型分析;用HAMD量表评定抗抑郁药的疗效。结果抑郁症5-HTT基因型频率(LL 24.3％,LS 44.6％,SS 31.1％)、等位基因频率(L 46.6％,S 53.4％)与正常对照组基因型频率(LL29.0％,LS 47.0％,SS 24.0％)、等位基因频率(L 52.5％,S 47.5％)比较没有显著性差异(P>0.05);不同基因型抑郁症患者治疗前,HAMD总分有显著差异(P<0.01);经4周SSRIs和SNRIs类抗抑郁药治疗后,HAMD总分均显著下降,减分值有显著差异(P<0.05)。结论中国人群中5-HTT基因多态性与抑郁症的发病不存在相关性,但与抑郁症疾病严重程度和抗抑郁药治疗效存在显著的相关性,这一区域的基因型可能成为抑郁症患者实现个体化治疗的一个参考指标。

Relationship between 5-HTT gene polymorphism and clinical response in the treatment of depressive patients with SSRIs and SNRIs

Objective To investigate the relationship between serotonin transporter (5-HTT) gene polymorphism and clinical response of selective serotonin reuptacke inhibitors(SSRIs) and selective serotonin and noradrenline reuptacke inhibitors (SNRIs) in the treatment of Chinese depressive patients. Methods Polymerase chain reaction (PCR) was used to detect the polymorphism of 5-HTT gene in 148 depressive patients and 100 healthy volunteers. The depressive states were assessed with hamilton depression rating scale (HAMD). Results There were no significant differences of the 5-HTT polymorphism genotypes and alleles between 148 depressive patients (LL 24.3%, LS 44.6%, SS 31.1%; L 46.6%, S 53.4%) and 100 controls (LL 29.0%, LS 47.0%, SS 24.0%; L 52.5%, S 47.5%)(P> 0.05). The HAMD of pretreatment were significant differences in depressive patients with different 5-HTT genotype (P<0.01). The HAMD reductive date after 4 weeks SSRIs and SNRIs post-treatment were significant differences in depressive patients with different 5-HTT genotype (P<0.05). Conclusion The 5-HTT polymorphism was not associated with depression, but was associated with disease serious degree and antidepressant clinical responses in depressive patients.