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急性戒断期伴与不伴震颤谵妄的酒精中毒患者血清脑源性神经营养因子水平的差异模式。

Differential patterns of serum brain-derived neurotrophic factor levels in alcoholic patients with and without delirium tremens during acute withdrawal.

机构信息

Graduate Institute of Medical Sciences, Taipei Medical University, Taiwan.

出版信息

Alcohol Clin Exp Res. 2011 Jan;35(1):126-31. doi: 10.1111/j.1530-0277.2010.01329.x. Epub 2010 Oct 6.

Abstract

BACKGROUND

Brain-derived neurotrophic factor (BDNF) is associated with alcohol addiction and withdrawal-related neurotoxicity. Delirium tremens (DT) is the most serious complication of alcohol withdrawal syndrome (AWS). In this study, we explored the differences in serum BDNF levels, measured at baseline and 1 week after alcohol withdrawal among alcoholic patients with and without DT.

METHODS

Sixty-five inpatients, fulfilling the DSM-IV criteria of alcohol dependence and admitted for alcohol detoxification, as well as 39 healthy control subjects were enrolled. The alcoholic patients were divided by the appearance of DTs into the DT group (n = 25) and non-DT group (n = 40). We collected blood samples of the patient groups on the first and seventh days of alcohol withdrawal and measured serum BDNF levels by sandwich enzyme-linked immunosorbent assay.

RESULTS

Serum BDNF levels differed significantly among the three groups: (i) control group 14.8 ± 4.7 ng/ml; (ii) non-DT group 12.3 ± 3.3 ng/ml; (iii) DT group 6.2 ± 2.6 ng/ml (p < 0.001). One week after alcohol withdrawal, the BDNF levels increased significantly for both alcoholic groups. While non-DT group had comparable BDNF levels (13.4 ± 3.5 ng/ml) with controls, the DT group still exhibited lower levels (8.9 ± 4.4 ng/ml).

CONCLUSIONS

This study suggests chronic drinking leads to a reduction in BDNF levels, and patients with more deficient BDNF expression are vulnerable to the development of DTs. Additionally, BDNF levels elevated after prompt alcohol detoxification treatment. These findings indicate that BDNF could involve modifying the phenotypes of AWS as well as the pertinent neuroadaptive processes of alcohol dependence.

摘要

背景

脑源性神经营养因子(BDNF)与酒精成瘾和戒断相关的神经毒性有关。震颤谵妄(DT)是酒精戒断综合征(AWS)最严重的并发症。在这项研究中,我们探讨了酒精依赖患者在戒酒后第 1 天和第 1 周之间,有无 DT 时血清 BDNF 水平的差异。

方法

共纳入 65 名符合 DSM-IV 酒精依赖标准并接受酒精解毒治疗的住院患者,以及 39 名健康对照者。根据是否出现 DT,将酒精依赖患者分为 DT 组(n = 25)和非 DT 组(n = 40)。我们在患者入院第 1 天和第 7 天采集血液样本,通过夹心酶联免疫吸附试验测定血清 BDNF 水平。

结果

三组间血清 BDNF 水平差异显著:(i)对照组 14.8 ± 4.7 ng/ml;(ii)非 DT 组 12.3 ± 3.3 ng/ml;(iii)DT 组 6.2 ± 2.6 ng/ml(p < 0.001)。戒酒后第 1 周,两组酒精依赖患者的 BDNF 水平均显著升高。非 DT 组的 BDNF 水平(13.4 ± 3.5 ng/ml)与对照组相当,而 DT 组仍较低(8.9 ± 4.4 ng/ml)。

结论

本研究表明慢性饮酒会导致 BDNF 水平降低,BDNF 表达水平较低的患者更容易出现 DT。此外,BDNF 水平在急性酒精解毒治疗后升高。这些发现表明 BDNF 可能参与调节 AWS 的表型以及酒精依赖的相关神经适应过程。

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