中文摘要：

目的：探讨自由基、抗氧化酶在双相障碍抑郁发作病理机制中的作用。方法：采用病例一对照研究设计，对56例符合美国精神障碍诊断与统计手册第4版诊断标准的门诊及住院双相障碍抑郁发作患者（包括双相I型组23例及双相Ⅱ型组33例）以汉密尔顿抑郁量表（Hamilton Depression Scale，HAMD）评定抑郁症状，并检测血浆丙二醛（malondialdehyde，MDA）、超氧化物歧化酶（superoxide dismutase，SOD）、过氧化氢酶（catalase，CAT）以及谷胱甘肽过氧化物酶（glutathione peroxidase，GSH-Px）含量，选择32名正常健康人作为对照（对照组），使用单因素方差分析以及多元线性回归分析比较各参数在组间差异及其与HAMD评分之间的关系。结果：双相I型和Ⅱ型组MDA水平均高于对照组，SOD、CAT及GSH－Px水平低于对照组，差异均有统计学意义；多因素分析显示，在控制身高、体质量指数和年龄等因素后HAMD评分与血浆MDA水平呈正相关（β=0．46，P〈0．05），与sOD（β=－0．27，P〈0．05）、CAT（β=-0．41，P〈0．05）和GSH—PX（β=一0．34，P〈0．05）水平呈负相关。结论：氧化应激反应可能参与双相障碍抑郁发作的发生过程，疾病严重程度可能与氧化应激反应失衡有关。

英文摘要：

Objective： To explore the role of free radicals and antioxidant enzymes in the pathogenesis of depression episode in bipolar disorder （BPD）. Methods： Fifty-six bipolar disorder patients from inpatient and outpatient department comprising of 23 ones with BPD I and 33 ones with BPD II were recruited according to the Diagnostic and Statistical Manual of Mental Disorder Fourth Edition, and estimated using Hamilton Depression Scale （HAMD）. The biomarkers including malondialdehyde （MDA）, superoxide dismutase （SOD）, catalase （CAT） and glutathione peroxidase （GSH-Px） were measured both in patients and controls （32 subjects）. One-way ANOVA and linear multiple regression were conducted to compare the parameters between the groups and analyze the relationship with HAMD scores. Results： The level of MDA in both of BPD I and BPD Ⅱ groups was significantly increased compared to controls[ （45.7 ± 15.4） nmol/mL, （44. 5± 13.2） nmol/mL vs. （ 16. 2±5.7） nmol/mL, Ps 〈 0. 01]. The levels of SOD[ （4032. 5 ± 1538.3） U/gHb, （4073.0± 1736. 2） U/glib vs. （5989. 5 ±1221.4） U/glib, Ps〈0.05],CAT[（12.7±0.5 vs 12.1 ±1.2 vs 18.3 ±0.7） U/ml, P〈0.01] and GSH-Px [（29.7±7.2）U, （ 30. 7± 10. 6） U vs. （ 38. 3 ± 5.3） U, Ps 〈 0. 01 ] in both of BPD I and BPD 1I groups were significantly lower than those in controls. The results of multiple linear regression analysis showed that after adjusted by body mass index （BMI）, age, sex, education and course of disease, the severity of depression symptoms were positively correlated with MDA （β =0. 46, P 〈0. 05）, and negatively correlated with SOD （β= -0. 27, P 〈0. 05）, CAT （β = -0.41, P〈0. 05） and GSH-Px （β = - 0. 34, P 〈0. 05）. Conclusion： The free radicals and antioxidant enzymes may be involved in the pathology of bipolar disorder, and the severity of depression symptoms is correlated with the imbalanee of oxidative stress.