利培酮抗精神病疗效与S100B蛋白相关性研究

目的 探讨利培酮抗精神分裂症疗效与S100B蛋白的相关性,为临床合理用药提供参考.方法 采用PANSS评价60例精神分裂症患者利培酮疗效,以HPLC-MS进行血药浓度监测,维持整体有效剂量,同时ELISA测定血浆中S100B蛋白浓度,分析利培酮疗效与S100B蛋白水平的相关性.结果 利培酮和9-羟利培酮第2,4,6周稳态血药浓度组内差异没统汁学意义.患者疗效PANSS分值,与治疗前分值相比,在第4周开始出现降低,并具有统汁学意义(P<0.05);与治疗前水平相比,血浆S100B浓度第2周开始出现降低,并具有统计学意义(P<0.05).S100B浓度变化与PANSS总分、阴性症状评分和阳性症状评分Pearson相关系数分别为r=0.860(P<0.01)、r=0.847(P=0.001)和r=0.589(P=0.044).在治疗第6周末,12例利培酮无效患者血浆S100B蛋白浓度为(0.12±0.07)μg·L~(-1),48例利培酮有效患者血浆S100B蛋白浓度为(0.03±0.01)μg·L~(-1),差异具有统计学意义(P=0.007).结论 利培酮对精神分裂症患者疗效较好,并能一定程度的降低患者较高的S100B水平,S100B蛋白与利培酮抗精神病治疗和精神分裂症患者病情变化发展有密切的相关性,具有重要的临床意义.

A study of correlation between the anti-schizophrenia effects of risperidone and the levels of S100B protein

Objective To explore the correlation between the anti-schizophrenia effects of Risperidone and the levels of S100B protein for clinical rational use of drug. Methods The therapy effect of Risperidone treating 60 patients with schizophrenia would be appraised by PANSS score evaluation, and the blood drug levels were assayed by HPLC-MS for curative dose, furthermore the concentrations of S100B were detected by ELISA, analyzing the correlation between the and-schizophrenia effects of Risperidone and the levels of S100B protein. Results The steady plasma-drug concentrations of Risperidone and 9-hydroxyl-Risperidone had no statistical difference; compared with the evaluation score before treatment, many patients were improved in the 4th week, which had statistical significance (P<0.05) ; and compared with the levels of S100B before therapy, it would reduce in the 2nd week, which had statistical significance (P<0.05) ; moreover the Pearson correlation coefficients of S100B levels and PANSS Total, PANSS negative score and PANSS positive score were r=0.860(P<0.01) , r= 0.847( P = 0.01) and r = 0.589( P=0.044) respectively; at the end of the 6th week, the S100B levels of the patients with ineffective (12 cases) or effective (48 cases) Risperidone treatment were (0.12 ±0.07)μg· L~(-1) and (0.03±0.01)μg·L~(-1) respectively, which had statistical significance (P = 0.007). Conclusion Risperidone is much effective for the patients with schizophrenia and could reduce the high S100B levels in plasma to a certain extent; the S100B protein closed correlated with the anti-schizophrenia effects of Risperidone and the pathogenetic condition of patient, which has an important clinical significance.