5-羟色胺转运体基因多态性与抗抑郁剂治疗广泛性焦虑障碍疗效的关联

doi:10.12092/j.issn.1009-2501.2019.08.009

中国临床药理学与治疗学 ›› 2019, Vol. 24 ›› Issue (8): 903-909.doi: 10.12092/j.issn.1009-2501.2019.08.009

5-羟色胺转运体基因多态性与抗抑郁剂治疗广泛性焦虑障碍疗效的关联

林敏¹，沈仲夏²，钱敏才²，崔力军³，任列²，蔡敏²，沈鑫华²

¹湖州市第三人民医院临床心理科， ²湖州市第三人民医院心身科， ³湖州市第三人民医院检验科，湖州 313000，浙江

收稿日期:2018-12-14 修回日期:2019-04-21 出版日期:2019-08-26 发布日期:2019-08-30
通讯作者: 沈鑫华，男，研究方向：心身医学、广泛性焦虑障碍的优化治疗。 Tel：13757289039 E-mail：shenxinhuasun@sina.com
作者简介:林敏，女，本科，副主任医师，研究方向：心身医学、儿童青少年精神心理。 Tel：13732365777 E-mail：lm2883999@163.com
基金资助:
浙江省医药卫生科技计划项目（2015KYA213）；湖州市公益性技术应用研究（2014GY16）

Relationship between 5-HTT gene polymorphism and treatment response in the treatment of generalized anxiety disorder patients with anti-depressants

LIN Min ¹, SHEN Zhongxia², QIAN Mincai ², CUI Lijun³, REN Lie²,CAI Min ², SHEN Xinhua²

¹Department of Clinical Psychology, Huzhou 3rd Hospital, ² Department of Neurosis and Psychosomatic Diseases, Huzhou 3rd Hospital, ³ Department of Clinical Laboratory, Huzhou 3rd Hospital, Huzhou 313000, Zhejiang,China

Received:2018-12-14 Revised:2019-04-21 Online:2019-08-26 Published:2019-08-30

摘要/Abstract

摘要：

目的:探索5-羟色胺转运体(5-hydroxytryptamine transporter,5-HTT)基因多态性与抗抑郁剂治疗广泛性焦虑障碍(generalized anxiety disorder,GAD)疗效的关联性。方法:188例符合DSM-IV广泛性焦虑障碍诊断标准的患者接受艾司西酞普兰（n=117）或者文拉法辛缓释剂（n=71）治疗8周，疗效判定以汉密尔顿焦虑量表（hamilton anxiety rating scale, HAMA）评分减分率及HAMA评分来评定。对所有患者及169例正常对照组接受5-HTT基因多态性检测。结果:5-HTT各基因型（SS、LS、LL）及等位基因（S、L）在GAD病例组和对照组的分布差异无统计学意义（P>0.05）。5-HTT各基因型患者基线时HAMA评分差异无统计学意义（F=0.052，P=0.949）。所有患者中SS、LS、LL基因型治疗后HAMA减分值差异无统计学意义（F=0.748，P=0.475）。艾司西酞普兰治疗组SS、LS、LL基因型治疗后HAMA减分值差异无统计学意义（F=0.210，P=0.811）。文拉法辛缓释剂治疗组SS、LS、LL基因型治疗后HAMA减分值差异有统计学意义（F=3.505，P=0.036）,LL基因型患者HAMA减分值显著高于SS和LS基因型。结论:5-HTT基因多态性与GAD发病的易感性之间可能无直接关系。5-HTT基因多态性和艾司西酞普兰的疗效不相关，但LL基因型的GAD患者接受文拉法辛缓释剂治疗的疗效可能优于SS和LS基因型。

关键词: 5-羟色胺转运体, 抗抑郁剂, 广泛性焦虑障碍, 疗效

Abstract:

AIM: To explore the relationship between 5-HTT gene polymorphism and treatment response in the treatment of generalized anxiety disorder（GAD）patients with anti-depressants. METHODS: A total of 188 GAD patients who met the criteria of DSM-IV were treated with escitalopram (n=117) or venlafaxine(n=71) randomly for 8 weeks. The serum 5-HTT gene polymorphisms of all patients were detected, while Hamilton Anxiety Rating Scale (HAMA) scores were measured at baseline and after 8 weeks of treatment. A remission was defined as HAMA≤7 after 8 weeks' treatment, and a response was defined as HAMA reduction rate ≥50%. The serum 5-HTT gene polymorphisms of all healthy controls who well matched with GAD patients were also detected.RESULTS:There were no significant differences of the 5-HTT polymorphism genotypes and alleles between GAD and controls(P>0.05)．Baseline HAMA in different 5-HTT genotype had no significant differences （F=0.052，P=0.949）. The reduction of HAMA in SS,LS,LL genetypes after the treatment had no significant difference（F=0.748，P=0.475）. The reduction of HAMA in SS，LS，LL genetypes after the treatment of escitalopram had no significant difference（F=0.210，P=0.811）. The reduction of HAMA in SS，LS，LL genetypes after the treatment of venlafaxine had significant difference（F=3.505，P=0.036），the reduction of HAMA in LL genetype were higher than that in SS and LS genetypes.CONCLUSION: The 5-HTT polymorphism maybe was not associated with GAD and antidepressant clinical efficacy in GAD patients, but the efficacy of the LL genetype may be better than LS and SS genetypes after the treatment of venlafaxine.

Key words: serotonin transporter, antidepressants, generalized anxiety disorder, efficacy

中图分类号:

R749
R968

林敏，沈仲夏，钱敏才，崔力军，任列，蔡敏，沈鑫华. 5-羟色胺转运体基因多态性与抗抑郁剂治疗广泛性焦虑障碍疗效的关联[J]. 中国临床药理学与治疗学, 2019, 24(8): 903-909.

LIN Min, SHEN Zhongxia, QIAN Mincai, CUI Lijun, REN Lie, CAI Min, SHEN Xinhua. Relationship between 5-HTT gene polymorphism and treatment response in the treatment of generalized anxiety disorder patients with anti-depressants[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(8): 903-909.

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5-羟色胺转运体基因多态性与抗抑郁剂治疗广泛性焦虑障碍疗效的关联

Relationship between 5-HTT gene polymorphism and treatment response in the treatment of generalized anxiety disorder patients with anti-depressants

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