慢性精神分裂症患者IL-18基因-607C/A位点多态性、血清IL-18蛋白水平与认知损害的关联分析

目的 比较慢性精神分裂症患者和健康对照组外周血IL-18蛋白水平与认知功能的相关性，探讨认知功能损害与IL-18蛋白水平的关系。 方法 本研究入组温州康宁医院2012年1月—2014年12月住院患者158名慢性精神分裂症患者和150名健康对照者。采用重复性成套神经心理状态测验(RBANS)评定认知水平，酶联免疫法(ELISA)检测研究对象外周血IL-18水平，聚合酶链反应-限制性片段长度多态性方法(PCR-RFLP)检测IL-18基因-607C/A位点多态性,阳性和阴性症状量表(PANSS)检测患者的临床症状。 结果 慢性精神分裂症患者外周血IL-18水平显著高于健康对照组(P＜0.05)，RBANS总分、即刻记忆和延迟记忆分也显著低于健康对照组(P＜0.05)。相关分析发现，IL-18蛋白水平与RBANS总分和即刻记忆和延迟记忆因子分成正相关(P＜0.05)。进一步的回归分析发现，IL-18是RBANS总分和即刻记忆、延迟记忆的独立决定因素。 结论 免疫反应在精神分裂症的认知功能中起重要作用，IL-18在慢性患者中起神经保护性作用。 

An associative analysis of IL-18 gene-607 C/A polymorphism and interleukin-18 levels with cognitive impairment in patients with chronic schizophrenia

Objective To evaluate the relationship between the IL-18 levels and cognitive functionin patients with chronic schizophrenia. Methods We recruited 158 chronic patients and 150 normal control subjectsin our hospital between Jan.2012 and Dec.2014.Repeatable Battery for the Assessment of Neuropsychological Status(RBANS) was used to measure the cognitive level,Enzyme-Linked Immunosorbent Assay(ELISA) was performed to test the peripheral blood IL-18 level,polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect IL-18 gene-607C/A polymorphism,and Positive and Negative Symptom Scale(PANSS) was used to assess the clinical symptoms of patients. Results IL-18 levels were increased in chronic schizophrenia patients as compared to normal controls (P<0.01).RBANS total score and the subscales of immediate memory and delayed memory were lower in patients than normal controls(all P<0.001).In patients,IL-18 levels were positively associated with RBANS total score and the subscales of immediate memory and delayed memory(all P<0.05).Multiple regression analysis further confirmed that IL-18 was an independent contributor to RBANS total score and the aforementioned two indexes(all P<0.05). Conclusion The immune responses may play an important role in cognitive performance in schizophrenia.Although the underlying mechanisms for the associations of IL-18 with cognitive performance are still unknown,the positive correlations may implicate some potentially neuroprotective effects of IL-18 on cognition in chronic patients.