中文摘要：

目的探讨难治性抑郁症（Treatment．resistantdepression，TRD）外周血B细胞淋巴瘤白血病-2基因（B-celllymphomaLeukemia-2，Bcl-2）的表达及其在抗抑郁治疗后的变化。方法纳入TRD23例、非TRD26例与正常对照51名，抑郁症患者给予抗抑郁药物治疗8周，以汉密尔顿抑郁量表（HamiltonDepressionScale，HAMD）减分率评定疗效。用TaqMan探针及荧光实时定量法检测治疗前后抑郁症与正常人外周血白细胞Bcl-2基因表达水平。结果抑郁症组Bcl-2基因表达低于正常对照组[（1．845±1．234）vs（3．422±2．204）]（P〈0．01）；TRD组Bcl-2基因表达低于非TRD组及正常对照组[（1．361±0．731）vs（2．273±1．431）vs（3．422±2．204）]（F=11．468，P〈0．01）；TRD组和非TRD组患者经抗抑郁治疗后，HAMD量表平均减分率分别为62．23％和82．97％；TRD组经抗抑郁治疗后，Bcl-2基因表达（1．797±1．035）显著上升（P〈0．01），而非TRD组治疗后（2．623±1．785）基因表达上升无统计学差异（P〉0．05）。结论Bcl-2基因表达下降可能与抑郁症的病理生理机制有关．难治性抑郁症的Bcl-2表达水平下降更为明显．经抗抑郁治疗后Bcl-2表达水平上升。

英文摘要：

Objective To investigate the effects of antidepressants treatment on mRNA expression levels of B-cell lymphoma Leukemia-2 gene （Bcl-2） in peripheral blood mononuclear cells （PBMCs） from patients with treat- ment-resistant depression （TRD）, and whether can affect the levels of Bcl-2 mRNA expression. Methods Twenty- three patients with TRD, 26 patients with treatment-effective depression （NTRD） and 51 healthy controls were enrolled in the present study. Patients received antidepressants for 8 weeks and HAMD was used to examine the effects of antidepressants. The mRNA expression levels of Bcl-2 in PBMCs from 49 patients with major depressive disorder （MDD） were estimated using relative TaqMan real time quantitative reverse transcription polymerase chain reaction （RT-PCR）. Results The levels of Bcl-2 mRNA expression were significantly lower in PBMCs of MDD patients than those of healthy controls [（1.845 ± 1.234） vs. （3.422 ± 2.204）]（P 〈 0.01）; The mRNA expression levels of Bcl-2 were the lowest in patients with TRD among patents with treatment-effective depression and healthy control [ （1.361 ± 0.731） vs. （2.273 ± 1.431） vs. （3.422 ± 2.204）]（F = 11.468, P 〈 0.01）. After 8 week treatment, the average HAMD decrease rates of TRD were 62.23% in TRD patients and 82.97% in NTRD patients, respectively. The expres- sion levels of Bcl-2 mRNA were significantly increased in TRD patients （1.797 ± 1.035）（P 〈 0.05） but not in NTRD patients （2.623 ± 1.785） after antidepressant treatment. Conclusion This study demonstrates that the decrease in mRNA expression levels of Bcl-2 may be involved in the pathogenesis of major depressive disorder, espe- cially treatment-resistant depression. Acute antidepressant treatment can increase the mRNA expression of Bcl-2 only in NTRD patients.