慢性精神分裂症患者血清IL-2、IL-4和IL-10水平及与精神症状的相关性

目的探讨慢性精神分裂症患者血清白细胞介素2(IL-2)、白细胞介素4(IL-4)和白细胞介素10(IL-10)的水平变化及其与精神症状的相关性。方法于2012年12月-2013年10月在广州医科大学附属脑科医院采用抽签法选取符合《国际疾病分类(第10版)》(ICD-10)诊断标准的40例慢性精神分裂症住院患者为患者组,同期通过广告招募64例健康对照者为对照组。采用酶联免疫吸附试验(ELISA)检测两组血清IL-2、IL-4和IL-10水平,采用阳性和阴性症状量表(PANSS)评估患者组的精神症状。结果患者组血清IL-2水平高于对照组[(25.85±6.06)pg/m L vs.(12.63±1.90)pg/m L],差异有统计学意义(P0.05);两组血清IL-4水平[(7.36±1.54)pg/m L vs.(8.76±3.13)pg/m L]和IL-10水平[(4.29±0.87)pg/m L vs.(3.76±1.17)pg/m L]比较,差异均无统计学意义(P均0.05);患者组血清IL-2、IL-4和IL-10水平与病程、住院时长、抗精神病药治疗剂量及PANSS评分均无线性相关(P均0.05)。结论慢性精神分裂症患者的血清IL-2水平高于健康对照者,IL-4和IL-10水平与对照者比较未见差异;IL-2、IL-4和IL-10水平与患者的精神症状未见线性相关性。     

奥氮平对精神分裂症患者血清血管内皮生长因子 水平的影响及其与临床疗效的关系

目的 探讨奥氮平对首发精神分裂症患者血清血管内皮生长因子（VEGF）水平的影响 及其与临床疗效的关系。方法 纳入40 例首发精神分裂症患者（患者组）,经4 周单一奥氮平治疗,采 用阳性与阴性症状量表（PANSS）评估疗效。用酶联免疫吸附法测定患者治疗前后和40 名健康者（对 照组）血清VEGF 的水平。结果 患者组服药前血清VEGF 水平［（331.8±80.1）pg/ml］显著低于对照组 ［（506.1±211.5）pg/ml］,服药后血清VEGF 水平［（475.7±128.5）pg/ml］较治疗前明显上升,差异有统计 学意义（t=6.489,P＜ 0.05）,而与对照组比较差异无统计学意义（P＞ 0.05）;患者组服药后PANSS 评分低 于服药前（P＜ 0.05）,并且PANSS 总分减分率与血清VEGF变化呈正相关（r=0.439,P=0.005）。结论 血 清VEGF水平适合作为精神分裂症的生物标志物,有效的抗精神病治疗能提高血清VEGF水平,血清 VEGF 变化可能是评价抗精神病药物疗效的相关指标。     

首发未服药精神分裂症患者血清S100B蛋白浓度变化

目的 探讨血清S100B蛋白浓度与首发未服用抗精神病药的精神分裂症患者精神病理症状间的关系.方法 采用酶联免疫(ELISA)方法 检测64例首发未服用抗精神病药精神分裂症患者和66名正常对照的血清S100B蛋白浓度,比较2组间的差异;采用阳性和阴性症状量表(PANSS)评定精神病理症状,分析血清S100B蛋白浓度与PANSS评分、患者年龄、发病年龄、病程间的关系.结果 ①患者组血清S100B浓度明显高于对照组,筹异有统计学意义[(0.27±0.13)μg/L vs(0.11±0.04)μg/L,t=10.89,P＜0.001];②患者组中偏执型、瓦解型、未分化型、残留型4个亚组间血清S100B浓度的差异有统计学意义(F=4.63,P=0.006),残留型组明显高于偏执型组(P=0.001)、瓦解型组(P=0.012);且各亚型组均明显高于对照组(P＜0.001).③患者组血清S100B浓度与年龄、总病程、PANSS总分及其阴性症状因子分相关(r为0.36、0.46、0.42、-0.38,P均小于0.005).结论 首发未服药的精神分裂症患者血清S100B浓度升高,并与某些病理症状尤其是阴性症状关联,在一定程度上可反映疾病严重程度.     

精神分裂症首次发病未治疗患者血清脑源性神经营养因子水平测定

目的:了解首发精神分裂症未治疗患者脑源性神经营养因子(BDNF)水平的变化,为临床诊治提供一定的依据。方法:抽取初诊的住院或门诊符合ICD-10精神分裂症诊断标准首发未治疗患者计66例,正常对照组40例。入组后使用阳性和阴性症状量表(PANSS)判别精神症状程度,抽取晨血,测定血清BDNF浓度。结果:精神分裂症患者血清BDNF水平(21.35±3.94)ug/L,显著低于正常对照组[(23.68±6.14)ug/L,P0.05];未治疗时间与血清BDNF水平具有相关性(r=3.216,P0.05)。结论:精神分裂症患者未治疗期越长,BDNF水平下降越明显,提示BDNF水平或许是精神分裂症患者发展的生物学指标之一。     

首发精神分裂症血清神经调节蛋白-1、脑电图γ活动及认知功能相关研究

目的探讨首发精神分裂症患者血清神经调节蛋白-1(neuregulin-1,NRG-1)浓度变化及静息状态前额叶脑电图γ活动与临床症状和认知功能的相互关系。方法纳入53例首发精神分裂症患者和58名健康对照者,检测其血清NRG-1浓度,使用时频分析法采集脑电图位于前额叶FP1、FP2导联中的γ活动,采用阳性与阴性症状量表(positive and negative syndrome,PANSS)评估患者临床症状,MATRICS公认认知成套测验(MATRICS consensus cognitive battery,MCCB)进行认知功能评估。结果患者组血清NRG-1浓度低于对照组[(7.36±3.96)pg/m L vs.(11.02±8.78) pg/m L],差异有统计学意义(P=0.006)。两组间脑电图γ活动有统计学差异[39(73.6%) vs.14(26.4%), P0.001]。MCCB测试中患者组连线测验评分高于对照组(P=0.006),符号编码、言语记忆、迷宫、视觉记忆、语义流畅性评分低于对照组(P0.001)。患者组血清NRG-1浓度与脑电图γ活动(r=-0.542,P0.001)、PANSS(r=-0.360,P=0.009)及言语记忆(r=0.332,P=0.016)评分相关。脑电图γ活动与PANSS(r=0.278,P=0.046)、言语记忆(r=-0.442,P=0.001)、迷宫测验(r=-0.307,P=0.027)评分分别相关。结论血清NRG-1浓度、脑电图γ活动与首发精神分裂症患者的临床症状及部分认知功能障碍有一定相关性,提示精神分裂症早期即存在神经生化及神经电生理方面的异常反应,且两者相关。     

稳定期精神分裂症患者血管内皮生长因子水平及其与症状关系

目的探讨稳定期精神分裂症患者血清血管内皮生长因子(vascular endothelial growth factor,VEGF水平及其与临床症状的关系。方法纳入稳定期精神分裂症患者75例(患者组)和健康对照40名(对照组),采用流式多重蛋白分析技术(cytometric bead array,CBA)检测外周血清VEGF水平,采用阳性与阴性症状量表(positive and negative symptom scale, PANSS)评定患者临床症状。结果患者组VEGF水平较健康对照组低[M(QL,QU):3.77(2.61, 5.14)pg/mL vs. 6.21(4.37,11.16)pg/mL],差异有统计学意义(P0.01);不同性别、是否吸烟、是否有精神疾病家族史患者之间血清VEGF的水平差异均无统计学意义(P0.05);患者组血清VEGF水平与性别、年龄、受教育年限、首次发病年龄、首次住院年龄、总病程、用药剂量折合氯丙嗪剂量均无统计学相关性(P0.05)。患者组VEGF水平与PANSS总分(r=-0.27,P=0.03)、阴性症状分(r=-0.25,P=0.04)、反应缺乏症状群分(r=-0.26,P=0.02)呈负相关。结论稳定期精神分裂症患者血清VEGF水平低于健康对照,患者血清VEGF水平与临床症状严重程度存在一定联系。     

重复经颅磁刺激对首发精神分裂症患者血清脑源性神经营养因子的影响

目的分析高频重复经颅磁刺激(rTMS)对首发精神分裂症患者血清脑源性神经营养因子(BDNF)的影响。方法选取82例以阴性症状为主的首发精神分裂症患者,使用随机数表将82例患者分为对照组41例和观察组41例,2组均使用常规药物治疗,观察组同时予以真刺激治疗,对照组予以假刺激治疗,对比2组治疗结果。结果治疗4周后观察组PANSS(阳性和阴性症状量表)总分、阴性症状评分、一般病理评分及血清BDNF浓度均优于治疗前,且优于对照组(P0.05);对照组PANSS总分、阴性症状评分、阳性症状评分、一般病理评分及血清BDNF浓度与之前相比无明显变化(P0.05)。观察组BDNF浓度变化与PANSS总分及各因子的变化无明显相关性(P0.05)。结论rTMS可显著增加首发精神分裂症患者的血清BDNF水平,但血清BDNF水平变化与其临床症状的改善无明显相关性。     

首发未用药精神分裂症患者攻击行为与血清C反应蛋白的相关性

目的 探讨首发未用药精神分裂症患者血清C反应蛋白（CRP）水平及临床症状对攻击行为的影响。方法 选取2020年1月至2022年11月在山东省精神卫生中心门诊就诊或者住院治疗的164例首发未用药精神分裂症患者为研究对象。采用修改版外显攻击行为量表（MOAS）评估患者的攻击行为，根据MOAS结果将患者分为攻击组（86例）和非攻击组（78例）。采用阳性与阴性症状量表（PANSS）评定患者的临床症状。采用二项Logistic分层回归分析首发未用药精神分裂症患者有攻击行为的影响因素。结果 攻击组患者的血清CRP水平[2.97(2.46,3.47)mg/L比1.73(1.36,2.10)mg/L]、PANSS总分[（89.27±9.82）分比（83.47±8.04）分]、阳性症状因子评分[33.90(33.01,34.79)分比30.13(29.28,30.98)分]、兴奋激越因子评分[14.12(13.43,14.80)分比7.01(6.41,7.61)分]、MOAS总分[12.85(11.90,13.80)分比2.28(1.36,3.20)分]、言语攻击维度评分[1.28(1.15,1.41)...     

氨磺必利治疗首次发病的精神分裂症患者的随机对照研究

目的:比较氨磺必利及利培酮对首次发病的精神分裂症患者疗效及糖脂代谢的影响。方法:采用随机双盲法将86例首发精神分裂症患者分为研究组和对照组,每组43例;分别给予氨磺必利和利培酮治疗8周。治疗前后进行阳性和阴性症状量表(PANSS)和治疗中出现的症状量表(TESS)评分;测量体质量指数(BMI)、空腹血糖(FPG)、口服糖耐量实验2 h血糖(2h PG)、血清胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、高密度脂蛋白(HDL)、三酰甘油(TG)、总胆固醇(TC)。结果:治疗后两组PANSS评分明显下降(P均0.05),两组间PANSS评分及临床总有效率差异无统计学意义;研究组不良反应发生率(25.6%)明显低于对照组(62.8%)(P0.05);研究组治疗前后糖脂代谢指标(BMI、FPG、2h PG、FINS、HOMA-IR、HDL、TG和TC)比较差异无统计学意义;对照组BMI、FPG、2h PG、FINS、HOMA-IR、TG和TC水平较治疗前及研究组明显增高(P0.05或P0.001)。结论:氨磺必利对首发精神分裂症患者的疗效与利培酮相似,不良反应少,短期治疗不影响患者的糖脂代谢。     

首发精神分裂症血清脂联素及代谢指标与第二代抗精神病药引发肥胖相关性研究

目的通过检测首发精神分裂症患者(first-episode schizophrenic patients,FEP)服用第二代抗精神病药物(second generation antipsychotics,SGAs)8周前后的血清脂联素(adiponectin,APN)及代谢相关指标水平,探讨SGAs对首发精神分裂症患者APN的影响以及APN在SGAs引发肥胖中的作用。方法选取86例首发未服药的精神分裂症患者,及88名性别年龄相匹配的正常对照,患者组使用单一SGAs治疗8周,测定患者组治疗前、治疗8周末及对照组的体重、体质指数(body mass index,BMI)、腰臀比(waist-to-hip ratio,WHR)及空腹血糖(fasting plasma glucose,FPG)、甘油三酯(triglyceride,TG)、APN、空腹胰岛素(fasting insulin,FINS)等指标。结果患者组在治疗前APN水平低于对照组[(9.32±0.76)μg/m L vs.(10.9±0.66)μg/m L],FINS水平高于对照组[(12.68±11.70)μIU/m L vs.(6.47±2.87)μIU/m L],差异有统计学意义(P0.05)。与治疗前相比,患者组SGAs治疗8周后体重[(59.01±10.56)kg vs.(63.80±9.78)kg]、BMI[(21.74±3.57)kg/m2vs.(23.49±3.44)kg/m2]、WHR[(0.88±0.07)vs.(0.92±0.05)]、TG[(0.94±0.92)mmol/L vs.(1.63±1.08)mmol/L]和FINS水平[(12.68±11.70)μIU/m L vs.(20.27±15.02)μIU/m L]增加,差异均有统计学意义(P0.01),而患者组治疗后APN[(9.32±0.76)μg/m L vs.(8.03±0.68)μg/m L]及FPG[(5.04±1.01)mmol/L vs.(4.46±0.57)mmol/L]水平降低,差异均有统计学意义(P0.05)。在男性患者组中,基线APN水平与治疗后体重增加值呈正相关(r=0.548,P=0.005),女性患者组中该相关无统计学意义(P0.05)。结论首发精神分裂症患者在治疗前APN水平降低,SGAs可进一步降低患者APN水平;在男性患者中,基线APN水平对服药后的体重增加有预测作用。     

以阳性、阴性症状为主的首发精神分裂症患者血清蛋白因子水平与PANSS评分的相关性

目的探讨以阳性、阴性症状为主的首发精神分裂症患者血清白细胞介素-6(IL-6)、钙结合蛋白S100β(S100β)、神经营养因子-3(NT-3)三种蛋白因子的浓度水平差异以及与其阳性与阴性症状量表(PANSS)评分中阳性症状、阴性症状、认知、兴奋及抑郁情绪评分之间的相关性。方法以2014年1月-2015年11月于昆明医科大学第一附属医院精神科门诊及住院的首发精神分裂症患者为患者组,选取同期来自本院体检中心的健康体检者为对照组。采用酶联免疫吸附技术(ELISA)测定44例以阳性症状为主的首发精神分裂症患者(阳性组)、38例以阴性症状为主的首发精神分裂患者(阴性组)和78名健康对照者(对照组)血清中蛋白因子IL-6、S100β、NT-3的浓度,通过PANSS对患者组和对照组的阳性症状、阴性症状、认知功能、兴奋症状及抑郁情绪进行定量评估。结果 1三组血清IL-6浓度比较,差异有统计学意义(F=31.34,P0.01),两两比较,对照组IL-6浓度低于阳性组和阴性组,阳性组低于阴性组,差异均有统计学意义(P均0.05);2三组S100β浓度比较,差异有统计学意义(F=9.19,P0.05),两两比较,阳性组、阴性组的S100β浓度均高于对照组(P均0.05),两患者组间比较差异无统计学意义(P0.05);3三组NT-3浓度比较,差异有统计学意义(F=10.45,P0.05),两两比较,阳性组、阴性组NT-3浓度均低于对照组(P均0.05),两患者组间比较差异无统计学意义(P0.05)。阳性组血清NT-3浓度与兴奋评分呈正相关(r=0.38,P0.05)。结论以阴性症状为主的首发精神分裂症患者的神经炎症反应较以阳性症状为主的患者更强烈,以阳性症状为主的首发精神分裂症患者的异常兴奋可能与其细胞营养不足有关,以阳性症状为主的首发精神分裂症的病理机制可能与以阴性症状为主的首发精神分裂症不尽相同。     

吸烟的首发精神分裂症患者脑源性神经营养因子与精神症状认知功能关系的对照研究

目的探讨吸烟与非吸烟首发精神分裂症患者临床症状、认知功能与BDNF的相关性。方法符合美国精神障碍诊断与统计手册第四版(DSM-Ⅳ)诊断标准的首发精神分裂症住院患者81例,其中吸烟27例,非吸烟54例。采用阳性和阴性症状量表(PANSS)、威斯康星卡片分类(WCST)、重复性神经心理测查系统(RBANS)评估精神症状和认知功能,采用酶联免疫吸附法检测血清BDNF水平。结果吸烟组PANSS总分、阴性症状分、一般精神病理症状分均高于非吸烟组(t=2.5,2.0,2.0,P均0.05),吸烟组的正确应答数显著高于非吸烟组,吸烟组错误应答数显著低于非吸烟组(t=2.02,-2.26,P均0.05)。吸烟组患者血清BDNF水平为(8.8±4.6)μg/L,非吸烟组为(9.2±4.3)μg/L,两组比较差异不显著,无统计学意义(t=0.38,υ=83,P0.05);吸烟患者BDNF与患者总病程、PANSS总分、一般精神病理症状分呈显著正相关(r=0.66,0.54,0.54,P均0.05);与RBANS词汇回忆、故事回忆、图形回忆、编码测验分值、延时记忆因子呈显著负相关(r=-0.48,-0.45,-0.45,-0.53,P均≤0.05);非吸烟患者BDNF与PANSS中阳性症状分呈显著正相关(r=0.27,P0.05)。结论吸烟精神分裂症患者BDNF水平与精神症状可能存在相关性。     

Association between serum testosterone levels and the severity of negative symptoms in male patients with chronic schizophrenia

OBJECTIVES: Dysfunction of the hypothalamic-pituitary-gonadal axis may contribute to the pathophysiology of schizophrenia. Recent neuroendocrinological studies have suggested that gonadal sex hormones, including androgens and estrogen, play a significant role in the pathophysiology of schizophrenia. The purpose of this study was to determine any correlation between negative symptoms and the plasma levels of free testosterone, total testosterone, dehydroepiandrosterone sulfate, estradiol, and prolactin with consideration to depressive symptoms, extrapyramidal symptoms (EPS), and other factors including differences in age, diurnal variation of the serum hormone levels, and body fat composition. METHODS: The subjects were 35 male inpatients with chronic schizophrenia aged 20-39 years. The patients' psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). The Calgary Depression Scale for Schizophrenia (CDSS) and the Drug-induced EPS scale (DIEPSS) were also used to exclude the effects of depression or drug-induced movement disorders. RESULTS: The PANSS negative scores had a significant inverse correlation with the serum total and free testosterone levels. The other hormone levels were not correlated with the PANSS negative scores. Moreover, a partial correlation analysis showed an inverse correlation between the PANSS negative subscores and the serum total and free testosterone levels after controlling for the DIEPSS and/or CDSS scores and age. CONCLUSIONS: This study indicates that total and free testosterone may play an important role in the severity of negative symptoms in male patients with schizophrenia.     

Serum levels of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in depressed patients with schizophrenia

Aim: Brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) are neurotrophins—proteins that induce the survival, development, and function of neurons. Their role in the development of schizophrenia and mood disorders is widely studied. This study was aimed to determine whether depression affects levels of BDNF and NT-3 in patients with schizophrenia. Methods: Data for 53 Caucasian adult hospitalized patients with chronic paranoid schizophrenia was compared with 27 healthy subjects. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and positive, negative and general sub-scores, the Calgary Depression Scale for Schizophrenia (CDSS), the Hamilton Depression Rating Scale (HDRS), and the Clinical Global Impressions scale (CGI). Patients were defined as depressed (SHZ-DEP) with scores CDSS?>?6 and HDRS?>?7, otherwise they were included into the non-depressed group (SHZ-nonDEP). Results: In total, 17 patients (32.1%) with schizophrenia met criteria for depression. SHZ-DEP patients had higher scores in HDRS, CDSS, PANSS total, PANSS negative, PANSS general and CGI (p?p?=?0.045. NT-3 levels were higher in SHZ-DEP compared to SHZ-nonDEP: 133.31?±?222.19 versus 56.04?±?201.28 pg/mL, p?=?0.033. Conclusion: There were no differences in neurotrophin levels between patients with schizophrenia and controls. We found lower BDNF and higher NT-3 serum levels in depressed patients with schizophrenia.     

氟哌啶醇与奥氮平治疗精神分裂症疗效和安全性的随机对照研究

目的比较氟哌啶醇与奥氮平治疗精神分裂症的疗效及安全性。方法将符合精神分裂症诊断标准的住院患者按照1:2比例随机分为氟哌啶醇(n=120)和奥氮平治疗组(n=252),进行为期6周的治疗观察;于基线及治疗2、4、6周末评定阳性和阴性症状量表(positive and negative syndrom scale,PANSS),锥体外系副反应量表(rating scale for extrapyramdal side effects,RSESE)、静坐不能评定量表(barnes akathisia rating scale,BARS)和异常不自主运动量表(abnormal involuntary movement scale,AIMS);计算体质量指数(body mass index,BMI);基线及治疗4、6周末测定空腹血糖、血脂和肝功能等指标。结果氟哌啶醇组与奥氮平组基线PANSS总分差异无统计学意义;第6周末氟哌啶醇组PANSS总分低于奥氮平组(53.31±1.64 vs.58.05±1.02),减分率高于后者(60.63±2.86%vs.52.45±1.80%),均P<0.05;两组有效率(66.7%vs.62.7%)差异无统计学意义。第6周末氟哌啶醇组BMI较基线的变化值(0.08±0.20 kg/m2vs.0.91±0.12 kg/m2)、谷丙转氨酶异常病例数比例(16.98%vs.28.07%)均低于奥氮平组(P<0.05);第4周末氟哌啶醇组甘油三酯较基线的变化值低于奥氮平组(0.24±0.12 mmol/L vs.0.57±0.07 mmol/L),P<0.05。氟哌啶醇组锥体外系不良反应发生率(73.3%)明显高于奥氮平组(10.71%),P<0.05。结论在精神分裂症急性期,氟哌啶醇治疗有效率与奥氮平相当,对体重、血脂、转氨酶的影响较小,但锥体外系不良反应发生率较高。     

Low serum levels of brain-derived neurotrophic factor in patients with schizophrenia do not elevate after antipsychotic treatment

Brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the etiology of schizophrenia. There is a line of evidence that disruption of neurotrophins could play a role in the etiology of schizophrenia, and antipsychotics show their effect by altering levels of neurotrophins. The aim of this study was to evaluate the effect of antipsychotics on serum BDNF levels and their relationship with the symptoms in patients with schizophrenia. Twenty-two schizophrenia patients were enrolled in the study. The control group consisted of 22 age- and sex-matched physically and mentally healthy volunteers (7 male, 15 female). Serum BDNF levels and the positive and negative syndrome scale (PANSS) scores were recorded at baseline and after 6 weeks of treatment. Serum BDNF levels were also recorded in the control group. Schizophrenia patients who failed to meet 30% improvement in PANSS score were excluded from the study. The baseline serum BDNF levels of schizophrenia patients were lower than those of controls (t = 4.56; df = 21; p < 0.001). There was no correlation between serum BDNF levels and PANSS scores in patients with schizophrenia (p > 0.05). Although PANSS (for positive symptoms p < 0.001, for negative symptoms p < 0.001) and general psychopathology (t = 20.9; df = 22; p < 0.001) scores improved significantly after 6 weeks of antipsychotic treatment; there was no change in BDNF levels in patients' serum (p > 0.05). Our results support the view that BDNF would be associated with schizophrenia. However, we could not conclude that treatment with antipsychotics alters serum BDNF levels in patients with schizophrenia.