利培酮对精神分裂症认知功能和血清细胞因子水平的影响

目的探讨利培酮对精神分裂症认知障碍的影响及其与血清白介素-2(IL2)、可溶性白介素-2受体(sIL2R)水平变化的关系。方法对符合中国精神障碍分类与诊断标准第3版(CCMD-3)精神分裂症诊断的60例患者予利培酮治疗6周;治疗前后分别采用数字划销测验(CT)、修订韦氏成人记忆量表(WMS-RC)、威斯康星卡片分类测验(WCST)评估注意功能、记忆功能和执行功能,同时采用酶联免疫吸附法(ELISA)检测血清IL2、sIL2R水平。对60名健康人(对照组)进行相同的认知功能和血清细胞因子检测。结果治疗前精神分裂症患者组认知功能测验成绩显著差于对照组(P<0.01),血清IL2水平显著高于对照组(P<0.05)。通过6周的利培酮治疗,CT的净分及WMS-RC的记忆商数均有显著提高,CT的失误率及WCST的总测验次数、持续错误数、随机错误数均显著下降,同时血清IL2水平显著降低,而sIL2R水平变化不明显;治疗前患者的失误率与血清IL2水平呈显著正相关(P<0.05),记忆商数与血清IL2水平呈显著负相关(P<0.05),治疗6周末失误率下降值和记忆商增加值均与血清IL2水平下降值呈显著正相关(P<0.05)。结论利培酮对精神分裂症注意、记忆功能的改善与降低的血清IL2水平相联系;精神分裂症认知功能障碍的部分特质可能与其紊乱的免疫功能(特别是细胞因子)有关。

The influence of risperidone on cognitive function in schizophrenia and serum interleukin levels

Objective To observe the influence of risperidone on cognitive impairment of patients with schizophrenia and investigate the correlation of plasma IL-2 and IL-2R levels with cognitive impairment. Method Attention, memory and executive function were tested with Cancellation Test(CT), Wechsler Memory Scale(WMS) and Wisconsin Card Test (WCST), the plasma IL-2 and IL-2R levels were measured with ELISA, respectively. Same cognitive tests and measure of serum interleukin levels were made in 60 cases of normal group. Result Before treatment, in schizophrenic group, the scores of cognitive test were significantly lower than those in normal group (P<0.01), and the plasma IL-2 levels were significantly higher than those in normal group (P<0.05). After treatment with risperidone for 6 weeks, both the net scores of CT and the memory quotient of WMS-RC were improved, the erroneous rate of CT and the total trials, perseverative errors ,random errors of WCST were all decreased , at the same time the level of plasma IL-2 was significantly decreased, the level of plasma SIL-2R was not significantly changed. Before treatment, there was a positive significant correlation between the plasma IL-2 levels and the scores of erroneous rate of cancellation(P<0.05), there was a negative significant correlation between plasma IL-2 levels and MQ(P<0.05). There was a significant positive correlation between the decrease of plasma IL-2 and the erroneous rate decrease, and MQ increase (P<0.05). Conclusion Risperidone improve cognitive function of schizophrenia probably by decreasing the levels of plasma IL-2.The cognitive dysfunction may be partly related to the disorderly immunity in schizophrenia.