精神分裂症首次发病患者冲动和自杀行为与血浆瘦素及总胆固醇的相关性研究

目的 探讨精神分裂症患者冲动、自杀行为与血浆瘦素及胆固醇之间的相关性.方法 106例精神分裂症首次发病患者用简明精神病评定量表(BPRS)、阳性和阴性症状量表(PANSS)、汉密尔顿抑郁量表(HAMD24)及Beck绝望量表(BHS)进行评定;按有无冲动、自杀行为分为自杀组(24例)、冲动组(31例)、非自杀非冲动组(以下简称患者对照组,51例),32名体检职工为正常对照组,所有入组对象(患者在服药前)测定体质量指数(BMI)、血浆瘦素和总胆固醇.结果 (1)正常对照组(4.8±0.9)mmol/L]和患者对照组(4.3±1.1)mmol/L]总胆固醇均高于自杀组(3.7±1.0)mmol/L]及冲动组(3.6±1.0)mmoL/L;P<0.05～0.01],而冲动组与自杀组之间、正常对照组与患者对照组之间的差异无统计学意义(P>0.05);正常对照组血浆瘦素(13.4±6.7)μg/L]高于患者对照组(8.9±3.8)μg/L]、自杀组(6.7±2.6)μg/L]及冲动组(5.6±4.2)μg/L;P<0.05～0.01],患者对照组高于自杀组及冲动组(P<0.05),而自杀组与冲动组的差异无统计学意义(P>0.05).(2)4组的血浆瘦素及总胆固醇均与BMI呈正相关(r=0.49～0.64;P<0.01);自杀组、冲动组的血浆瘦素和总胆固醇与PANSS阳性分、PANSS攻击分、BPRS分、HAMD分、BHS分均呈显著负相关(r=-0.35～-0.72;P<0.05～0.01);患者对照组的血浆瘦素、总胆固醇与PANSS攻击分、BPRS分、HAMD分、BHS分均呈显著负相关r=-0.29～-0.48;P<0.05～0.01).结论 精神分裂症患者的冲动、自杀行为及疾病严重程度与血浆瘦素及总胆固醇有一定的相关性.

Correlation between impulse, suicidal behavior and plasma leptin in first-episode schizophrenic patients

Objective To investigate the correlation between impulse, suicidal behavior and plasma leptin and total cholesterol in first-episode schizophrenic patients. Methods According to their history of suicide and impulse behavior, 106 first-episode schizophrenic patients were divided into 3 groups: suicide group (n=24), impulse group (n=31) and non-suicide-non-impulse group (n=51), and assessed with the Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Scale (HAMD24) and Beck Hopelessness Scale (BHS), Thirty-two individuals who took part in health examination were selected as health control group. Body mass index (BMI), plasma leptin and total cholesterol were measured from all subjects before taking medication. Results (1) The plasma leptin level was higher in healthy control group(13.4±6.7) μg/L] than non-suicide-non-impulse group(8.9±3.8) μg/L], suicide group(6.7±2.6) μg/L] and impulse group (5.6±4.2) μg/L; P<0.05-0.01], and with significant differences between non-suicide-non-impulse group, suicide group and impulse group (P<0.05), but no significant difference between suicide group and impulse group (P>0.05). The plasma levels of total cholesterol in healthy control group and non-suicide-non-impulse group were higher than in suicide group and impulse group (P<0.05-0.01), with no significant difference between suicide groupand impulse group (P>0.05), and between healthy control group and non-suicide-non-impulse group (P>0.05). (2) In suicide group and impulse group, plasma leptin and total cholesterol were negatively correlated with PANSS positive score, PANSS attack score, BPRS score, HAMD score and BHS score. Plasma leptin and total cholesterol in non-suicide-non-impulse group were negatively correlated with PANSS attack score, BPRS score, HAMD score and BHS score. Conclusion Impulse and suicidal behavior and illness severity of schizophrenic patients may be correlated with plasma leptin and total cholesterol.