标题：腹型肥胖对双相障碍抑郁发作患者氧化应激指标的影响

      作者：程小燕 1，吕钦谕 1，鲍晨曦 1，耿瑞杰 1，王颖怡 1，顾琪 1，陆燕华 1，张平 2，易正辉 1    (1.上海交通大学医学院附属精神卫生中心，上海 200030；2.上海市奉贤区精神卫生中心，上海 201418)

      卷次： 2018年29卷19期

      【摘要】 目的 探讨腹型肥胖对双相障碍抑郁发作患者氧化应激指标的影响。方法 选取 2014年 6月至2016年 12月就诊于上海交通大学医学院附属精神卫生中心门诊或住院部的双相障碍抑郁发作患者 43例，按腰围分为非腹型肥胖组(BP1组) 33例和腹型肥胖组(BP2组) 10例，同时选取无腹型肥胖的健康对照(HC组) 45例，收集三组受检者的临床资料，采用 17项汉密尔顿抑郁量表(HAMD-17)、杨氏躁狂量表(YMRS)、阳性和阴性症状量表(PANSS)评估患者症状严重程度，检测并比较各组受检者的外周血超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)及丙二醛(MDA)的含量。结果 BP1组、BP2组和HC组受检者的 SOD[(126.06±16.28) nmol/mL、(122.77±18.45) nmol/mL、(137.24±12.25) nmol/mL]、GSH-Px [(180.05±31.54) U、(189.27±32.28) U、(150.68±20.13) U]和MDA [(4.21±1.87) U/mL、(4.51±2.13) U/mL、(2.83±0.60) U/mL]比较差异均有统计学意义(P<0.05)，两两比较显示，BP2组和BP1组患者的外周血中GSH-Px和MDA的含量均明显高于HC组，差异均有统计学意义(P<0.05)，而SOD的含量均低于HC组，差异均有统计学意义(P<0.05)；BP1组、BP2组和HC组受检者的CAT含量分别为(1.33±0.59) U/mL、(1.44±0.85) U/mL、(1.24±0.49) U/mL，差异无统计学意义(P>0.05)；BP2组患者住院次数为(1.90±2.18)次、PANSS总分为(63.8±18.64)分，较BP1组患者的(0.52±0.76)次和(57.24±10.32)分增加，差异均有统计学意义(P<0.05)；BP1和BP2组患者的HAMD-17总分分别为(24.03±6.29)分、(20.6±6.84)分，YMRS总分分别为(3.85±6.24)分、(1.8±1.93)分，差异无统计学意义(P>0.05)。结论 双相障碍抑郁发作患者存在氧化和抗氧化失衡，但未发现腹型肥胖对双相障碍抑郁发作患者氧化应激水平有影响，但双相障碍患者共病腹型肥胖较未共病腹型肥胖者临床症状更加严重，医疗负担增加。
      【关键词】 双相障碍；抑郁发作；腹型肥胖；氧化应激
      【中图分类号】 R749.4 【文献标识码】 A 【文章编号】 1003—6350（2018）19—2685—04

Effect of abdominal obesity on oxidative stress during depressive episode in patients with bipolar disorder.CHENG Xiao-yan 1, LV Qin-yu 1, BAO Chen-xi 1, GENG Rui-jie 1, WANG Ying-yi 1, GU Qi 1, LU Yan-hua 1, WANG Ping 2, YIZheng-hui 1.
1. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030,CHINA; 2. Fengxian District Mental Health Center of Shanghai, Shanghai 201418, CHINA
【Abstract】 Objective To investigate the effect of abdominal obesity on oxidative stress indexes during depres-sive episode in patients with bipolar disorder. Methods From June 2014 to December 2016, 43 patients with bipolardisorder during depressive episodes in the Outpatient Department or Inpatient Department in Shanghai Mental HealthCenter, Shanghai Jiao Tong University School of Medicine were enrolled. According to the waist circumference, the pa-tients were divided into non-abdominal obesity group (BP1 group, 33 cases) and abdominal obesity group (BP2 group,10 cases). Forty-five healthy controls (HC) without abdominal obesity were selected as the HC group. The clinical dataof the three groups of subjects were collected, and the severity of symptoms was assessed using 17-item Hamilton De-pression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS), and Positive and Negative Symptom Scale(PANSS). The levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and malondial-dehyde (MDA) in peripheral blood of each group were measured and compared between groups. Results The levelsof SOD in BP1 group, BP2 group, HC group were (126.06 ± 16.28) nmol/mL, (122.77 ± 18.45) nmol/mL, (137.24 ±12.25) nmol/mL, respectively, and GSH-Px were (180.05±31.54) U, (189.27±32.28) U, (150.68±20.13) U, and MDAwere (4.21±1.87) U/mL, (4.51±2.13) U/mL, (2.83±0.60) U/mL, with statistically significant difference between the threegroups (P<0.05). The levels of MDA and GSH-Px in the peripheral blood of BP2 group and BP1 group were significant-ly higher than those in HC group (P<0.05), but the level of SOD was significantly lower than that of HC group (P<0.05).There was no significant difference in the levels of CAT among the three groups: (1.33±0.59) U/mL, (1.44±0.85) U/mL,·论 著·doi:10.3969/j.issn.1003-6350.2018.19.006基金项目：国家自然科学基金(编号：81671326)；“精准医学研究”国家重点专项(编号：2016YFC0906402)；上海交通大学文理交叉认知专项基金(编号：16JXRZ06)；上海市科学技术委员会科研计划项目(编号：17411970000)；上海市精神卫生中心院级课题(编号：2014-YJ-04、2015-YJGJ-03)