上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

5-HTR2A基因-1438A/G多态性与强迫症及舍曲林疗效的关联研究

刘延辉1，张心华2，张立霞1   

  1. 1.滨州市优抚医院精神科， 滨州 256612； 2.青岛大学医学院 心理学与精神病学教研室， 青岛 266000
  • 出版日期:2013-08-28 发布日期:2013-09-16
  • 作者简介:刘延辉（1974—）， 男， 主治医师， 硕士; 电子信箱: lyh747@sina.cn。

Association of 5-HTR2A gene -1438G/A polymorphisms with obsessive-compulsive disorder and efficacy of sertraline treatment

LIU Yan-hui1, ZHANG Xin-hua2, ZHANG Li-xia1   

  1. 1. Division of Psychiatry, Binzhou Youfu Hospital, Binzhou 256612, China; 2.Department of Psychiatry and Psychology, Medical School of Qingdao University, Qingdao 266000, China
  • Online:2013-08-28 Published:2013-09-16

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摘要：

目的 探讨五羟色胺2A受体(5-HTR2A)基因-1438G/A多态性与强迫症（OCD）的关联及舍曲林疗效之间的关系。方法 随机抽取127例OCD患者作为研究对象，舍曲林（最高剂量200 mg/d)治疗8周，采用耶鲁-布朗强迫量表(Y-BOCS)评定疗效。应用聚合酶链反应-限制性片段长度多态性技术对OCD患者和健康对照（对照组，n=224）的5-HTR2A功能基因进行遗传关联分析。结果 5-HTR2A基因-1438G/A多态性位点的等位基因和基因型分布频率的分析结果显示：OCD组与对照组等位基因分布频率的差异有统计学意义(P<0.05)，而基因型分布频率的差异无统计学意义(P>0.05)；舍曲林治疗有效组与无效组等位基因分布频率的差异无统计学意义（P>0.05)，而基因型分布频率的差异有统计学意义（P<0.05)；OCD女性组等位基因和基因型分布频率与对照组女性比较，差异均有统计学意义（P<0.05)；OCD早发组与对照组的基因型和等位基因分布频率的差异有统计学意义（P<0.05)；OCD早发组与晚发组基因型和等位基因分布频率的差异均有统计学意义（P<0.05)；OCD仅有强迫行为组与对照组的基因型和等位基因分布频率比较，差异均有统计学意义（P<0.05)。结论 5-HTR2A基因-1438A等位基因可能是OCD患者发病的危险因素；-1438G/A多态性可能与OCD患者为女性、起病早、仅有强迫行为有关；舍曲林治疗OCD患者的疗效与5-HTR2A基因-1438G/A多态性的基因型存在关联。

关键词: 强迫症, 五羟色胺受体, 基因多态性, 舍曲林

Abstract:

Objective To investigate the association of 5-HT2A receptor (5-HTR2A) gene -1438G/A polymorphisms with obsessive-compulsive disorder (OCD) and efficacy of sertraline treatment. Methods One hundred and twenty-seven patients with OCD were selected, and were treated with sertraline for 8 weeks, with 200 mg/d as the highest dose of sertraline. The efficacy was rated by Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Polymerase chain reaction-restriction fragment length polymorphism was used to detect -1438G/A polymorphisms of 5-HTR2A gene in patients with OCD and healthy controls (n=224). Results There were significant differences in the allele distribution frequencies between OCD group and control group (P<0.05), while there was no significant difference in the genotype distribution frequency between two groups (P>0.05). There was no significant difference in the allele distribution frequency between sertraline effective group and sertraline invalid group (P>0.05), while there were significant differences in the genotype distribution frequencies between two groups (P<0.05). There were significant differences in the allele distribution frequencies and genotype distribution frequencies between females in OCD group and those in control group (P<0.05), between OCD early onset group and control group (P<0.05), between OCD early onset group and OCD late onset group (P<0.05), and between patients only with obsessive-compulsive behavior in OCD group and control group (P<0.05). Conclusion 5-HTR2A gene -1438A allele may be the risk factor of development of OCD. -1438G/A polymorphism may be associated with female gender, early disease onset and obsessive-compulsive behavior as the only symptom in OCD. The genotype of 5-HTR2A gene -1438G/A polymorphisms may be associated with the efficacy of sertraline treatment in OCD.

Key words: obsessive-compulsive disorder, serotonin receptor, gene polymorphism, sertraline