精神分裂症患者脑脊液细胞学对照研究

目的探讨精神分裂症患者中枢神经系统免疫学改变的细胞学基础.方法对40例精神分裂症患者治疗前后各进行一次脑脊液细胞学检查,以9名外科手术腰麻脑脊液作对照.结果 (1)精神分裂症患者淋巴细胞减少,单核细胞增多,出现吞噬细胞,治疗前及治疗后与对照组相比差异有非常显著性(P＜0.001).(2)精神分裂症青春型治疗前的脑脊液淋巴细胞减少,单核细胞增多比偏执型更为突出(P＜0.01),治疗后这种差异消失.(3)精神分裂症治疗前病程在半年以内者脑脊液淋巴细胞减少比三年以上者突出,两者相比差异显著(P＜0.02),治疗后差异无显著性.结论提示精神分裂症患者中枢神经系统存在免疫反应,这种免疫反应可能参与了精神分裂症发病的病理过程.

A comparative study of cytology in the CSF of schizophrenic patients.

Objective To explore cytology's basis of immune changes in the central nervous system (CNS)of patients with schizophrenia.Methods Forty schizophrenic patients' CSF were analyzed and observed by light microscopy before and after treatment respectively. Nine CSF samples from operative surgical patients without CNS disease were set as com-parision. Results l) Lymphocytes significantly decreased and mononuclear cells remarkably increased in the CSF of schizophrenic patients than that of the comparison subjects( P < 0.001) . Meanwhile, macrophages were found in the CSF of most schizophrenic patients. 2) The number of lymphocytes remarkably decreased and mononuclear cells significantly increased in hebephrenic type's CSF than that of paranoid type(P< 0.01) before treatment, but after treatment, no significant difference was found. 3) Lymphocytopenia was significantly related to the duration of illness before treatment, and those with duration of less than half a year were more severe than those of beyond three years(P < 0.02) ,but there was no significant difference after treatment. Conclusion Schizophrenic patients may exist immunoactivation in the CNS, and it may probably play an important role in pathogenesis of schizophrenia.