陈红梅陈景旭陈大春周双桨张立刚王璇田成华王绍礼

双相情感障碍血清尿酸水平研究☆

陈红梅*△陈景旭△陈大春△周双桨△张立刚△王璇△田成华*王绍礼△

目的 探讨双相情感障碍患者血清尿酸（uric acid，UA）水平变化及其临床意义。 方法 纳入双相情感障碍患者126例（躁狂发作77例，抑郁发作49例）、首发精神分裂症患者69例和正常对照126名，测定其血清UA水平，并采用杨氏躁狂量表（Young mania rating scale，YMRS）和汉密尔顿抑郁量表（Hamilton depression scale，HAMD）评定双相情感障碍患者症状。 结果 双相情感障碍组血清UA水平［（349.34±107.21）μmol/L］高于精神分裂症组［（319.71±84.48）μmol/L］和对照组［（280.94±71.90）μmol/L］，差异有统计学意义（P＜0.01）；躁狂发作患者UA水平高于抑郁发作患者［（366.45±104.01）μmol/L vs.（322.45±107.69）μmol/L］，且二者均高于对照组（P＜0.01）；双相情感障碍患者中是否使用精神科药物的亚组间UA水平无统计学差异（P＞0.05）。双相情感障碍患者血清UA水平与YMRS、HAMD分数线性相关均无统计学意义（P＞0.05）。 结论 双相情感障碍患者血清UA水平升高，血清UA水平升高可能是双相情感障碍的一个生物标记物。

双相情感障碍 躁狂发作抑郁发作 尿酸

【Abstract】Objective To investigate the serum levels of uric acid（UA）in bipolar disorder patients and their clinical significance.Methods Serum levels of UA was measured in 126 bipolar disorder patients including 77 mania patients and 49 depression patients，69 first-episode schizophrenic patients and 126 healthy controls（control group）.Bipolar disorder patients was assessed by using the Young Mania Rating Scale（YMRS）and the Hamilton Depression Scale （HAMD）.Results The serum UA levels were significantly higher in bipolar group［（349.34±107.21）μmol/L］than in schizophrenic group［（319.71±84.48）μmol/L］and in control group［（280.94±71.90）μmol/L］（P＜0.01）.There were significant differences in serum UA levels between manic episode and depressive episode［（366.45±104.01）μmol/L vs. （322.45±107.69）μmol/L］.The serum UA levels were higher in both manic episode and depressive episode groups than in control group（P＜0.01）.The serum UA levels was not significantly different between patients with and without medication （P＞0.05）.Correlation analysis indicated that the correlation of serum UA levels with YMRS scores and HAMD scores was not significant in bipolar disorder patients（P＞0.05）.Conclusions Patients with bipolar disorder has elevated serum uric acid levels which may be a biomarkers of bipolar disorder.

【Key words】Bipolar disorder Depression Uric acid Hyperuricemia

近年研究表明，嘌呤功能紊乱可能在双相情感障碍的病理生理机制中起着重要作用［1-2］，但监测中枢嘌呤代谢情况较为困难，指导临床工作的便利性有限。尿酸（uric acid，UA）是人类嘌呤代谢的唯一终产物，监测血清UA水平可间接反映嘌呤代谢情况［3］。国外研究发现，双相情感障碍躁狂发作患者血清UA水平明显升高［4-5］，而关于双相情感障碍抑郁发作患者UA水平的文献较少。国内关于双相情感障碍UA水平的报道亦较少，且已有研究的样本量小，未对双相情感障碍不同临床相加以讨论，研究结论并不一致［6-8］。……