血清铜锌离子变化对双相障碍发作的影响

doi:10.3877/cma.j.issn.2095-9605.2016.04.009

目的

探讨血清铜锌离子变化对双相障碍发作的影响。

方法

回顾性分析2013年8月至2015年2月在暨南大学附属第一医院精神科接受诊治的64例双相障碍患者和30例健康志愿者的临床资料。其中男43例，女51例；平均年龄（28±10）岁。研究对象均签署知情同意书，符合医学伦理学规定。根据所处的心境状态将研究对象分为3组：双相障碍抑郁期组32例、双相障碍缓解期组32例和正常对照组30例。早晨空腹抽取静脉血检测研究对象的铜离子、锌离子和铜蓝蛋白浓度。3组研究对象临床和实验室数据的比较采用单因素方差分析，两两比较采用LSD-t检验；性别比较采用χ²检验。

结果

双相障碍抑郁期组研究对象的铜离子浓度、铜蓝蛋白浓度和铜/锌比值均低于正常对照组（LSD-t_铜离子=–2.32，LSD-t_铜蓝蛋白=–0.11，LSD-t_{铜/锌比值}=–0.74，P值均<0.05），而锌离子浓度高于正常对照组（LSD-t=3.28，P<0.05）。双相障碍缓解期组研究对象的铜离子浓度、铜蓝蛋白浓度和铜/锌比值高于双相障碍抑郁期组（LSD-t_铜离子=–3.94，LSD-t_铜蓝蛋白=–0.05，LSD-t_{铜/锌比值}=–0.79，P值均<0.05），而锌离子浓度低于双相障碍抑郁期组（LSD-t=2.51，P<0.05）。双相障碍缓解期组研究对象的铜蓝蛋白浓度低于正常对照组（LSD-t=–0.06，P<0.05），而铜离子浓度、锌离子浓度和铜/锌比值与正常对照组比较差异无统计学意义（P>0.05）。

结论

双相障碍抑郁期和缓解期组患者均存在微量元素铜、锌浓度的异常。铜、锌离子浓度的改变可能成为双相障碍微量元素监测的特征性表现之一，其变化机制仍在探索中。

关键词: 双相障碍, 微量元素, 铜, 锌

Objective

To explore the influence of changes of serum copper and zinc ions on the attack of bipolar disorder.

Methods

Clinical data of 64 bipolar disorder patients being diagnosed and treated and 30 healthy volunteers in the First Affiliated Hospital of Jinan University from August 2013 to February 2015 were retrospectively analyzed. Among the 94 subjects, 43 were males and 51 were females with an average age of (28±10) years old. The informed consents were obtained from all of the subjects and the local ethical committee approval had been received. According to the mood states, all the subjects were divided into 3 groups: 32 patients in the acute episode of bipolar disorder, 32 patients in the remission episode of bipolar disorder and 30 subjects in the control group. Copper ion, zinc ion and ceruloplasmin were tested by collecting every subject’s venous blood in fasting state in the morning. The comparisons of clinical and experimental data among the 3 groups were conducted using ANOVA analysis, with LSD-t test for pairwise comparison; and comparisons between two sexes were conducted using χ² test.

Results

The concentrations of copper ion and ceruloplasmin and copper/zinc ratio of the patients in acute episode of bipolar disorder were significantly lower than those of the control group (LSD-t=–2.32, –0.11, –0.74, P<0.05), but the concentration of zinc ion was higher than that of the control group (LSD-t=3.28, P<0.05). The concentrations of copper and ceruloplasmin and copper/zinc ratio of the patients in remission episode of bipolar disorder were higher than those of patients in acute episode (LSD-t=–3.94, –0.05, –0.79, P<0.05), but the concentration of zinc ion was lower than that of patients in acute episode (LSD-t=2.51, P<0.05). The concentration of ceruloplasmin of the patients in remission episode of bipolar disorder was lower than that of the control group (LSD-t=–0.06, P<0.05), but the concentrations of copper and zinc ions and copper/zinc ratio had no statistical difference with those of the control group (P>0.05).

Conclusions

The patients with bipolar disorder can encounter abnormal concentrations of copper and zinc in both acute and remission episodes. The concentration changes of copper and zinc ions may become one of the characteristic performances to monitor trace element for bipolar disorder; however, the changing mechanism remains to be investigated.

Key words: Bipolar disorder, Trace element, Copper, Zinc

表1 双相障碍抑郁期组、缓解期组和正常对照组研究对象基线资料比较

组别	例数	性别（例）		年龄（岁，±s）
组别	例数	男	女	年龄（岁，±s）
双相障碍抑郁期组	32	17	15	25±8
双相障碍缓解期组	32	11	21	29±11
正常对照组	30	15	15	30±10
统计值	?	χ²=0.681		F=2.092
P值	?	>0.05		>0.05

表1 双相障碍抑郁期组、缓解期组和正常对照组研究对象基线资料比较

组别	例数	性别（例）		年龄（岁，±s）
组别	例数	男	女	年龄（岁，±s）
双相障碍抑郁期组	32	17	15	25±8
双相障碍缓解期组	32	11	21	29±11
正常对照组	30	15	15	30±10
统计值	?	χ²=0.681		F=2.092
P值	?	>0.05		>0.05

表2 双相障碍抑郁期组、缓解期组和正常对照组研究对象微量元素比较（±s）

组别	例数	铜离子（μmol/L）	铜蓝蛋白（μmol/L）	锌离子（μmol/L）	铜/锌比值
双相障碍抑郁期组	32	14.0±4.1^a，b	0.34±0.07^a，b	12.6±2.1^a，b	1.1±0.5^a，b
双相障碍缓解期组	32	17.9±5.2	0.39±0.11^c	10.1±2.8	1.9±1.0
正常对照组	30	16.3±2.5	0.46±0.07	9.3±2.5	1.9±0.6
F值	?	7.50	14.24	15.19	11.51
P值	?	<0.05	<0.05	<0.05	<0.05

表2 双相障碍抑郁期组、缓解期组和正常对照组研究对象微量元素比较（±s）

组别	例数	铜离子（μmol/L）	铜蓝蛋白（μmol/L）	锌离子（μmol/L）	铜/锌比值
双相障碍抑郁期组	32	14.0±4.1^a，b	0.34±0.07^a，b	12.6±2.1^a，b	1.1±0.5^a，b
双相障碍缓解期组	32	17.9±5.2	0.39±0.11^c	10.1±2.8	1.9±1.0
正常对照组	30	16.3±2.5	0.46±0.07	9.3±2.5	1.9±0.6
F值	?	7.50	14.24	15.19	11.51
P值	?	<0.05	<0.05	<0.05	<0.05

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Influence of the changes of serum copper and zinc ions on the attack of bipolar disorder

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Influence of the changes of serum copper and zinc ions on the attack of bipolar disorder