精神分裂症患者嫉妒妄想与血清睾丸酮和雌二醇水平相关性分析

目的探讨精神分裂症患者嫉妒妄想的形成与患者血清睾丸酮、雌二醇水平变异的内部联系。方法将29例有嫉妒妄想的精神分裂症患者（研究组）、33例无嫉妒妄想的精神分裂症患者（对照组）分别于治疗前及治疗后采用放射免疫法进行男性血清睾丸酮（T）、女性雌二醇（E2）含量的测定并进行统计学比较。结果T及E2水平测量，经药物治疗嫉妒妄想未消失的患者治疗前、后自身比较无差异性（P〉0．05），嫉妒妄想消失的患者治疗前、后自身比较有差异性（P〈0．05），研究组与对照组比较有差异性（P〈0．05），与22例正常人组比较差异有显著性（P〈0．01）。结论精神分裂症患者嫉妒妄想的形成与血清睾丸酮（T）、雌二醇（E2）水平存在一定相关性。     

不同症状的精神分裂症患者事件相关电位研究

目的研究以不同症状为主的精神分裂症患者的事件相关电位。方法对16例阴性症状为主、19例阳性症状为主、21例混合型未服药的精神分裂症患者和15例正常对照组，进行ERPsN200、P300测查。结果三组精神分裂症患者中P300波幅与正常对照组相比均明显下降，差畀具有显著性（P〈0．05），只有阴性组P300的潜伏期与正常对照组相比明显延长（P〈0．05）；三组精神分裂症患者中T3点P300波幅与T4相比下降更明显（P〈0．05）；相关分析发现，阴性量表分与Fz的P300潜伏期显著正相关（r=0．33，P〈0．05）。结论不同症状为主的精神分裂症可能有不同的神经生物学基础。     

利培酮对精神分裂症首次发病患者血清脑源性神经营养因子水平的影响

目的：探讨利培酮对首发精神分裂症患者血清脑源性神经营养因子（BDNF）水平的影响。方法：采用酶联免疫吸附法测定40例首发精神分裂症患者（患者组）在给予利培酮治疗前和治疗8周后的血清BDNF水平,并与40名正常人（正常对照组）的血清BDNF水平进行比较。结果：治疗前患者组血清BDNF水平显著低于正常对照组（P〈0．05）,治疗8周,患者组血清BDNF水平较治疗前明显升高（P〈0．01）;与正常对照组差异无统计学意义（P〉0．05）。患者组中有阳性家族史者（8例）与阴性家族史者（32例）之间血清BDNF水平差异无统计学意义（P〉0．05）。患者组治疗前后血清BDNF水平与阳性与阴性症状量表评分（r=0．283,r=0．09;P〉0．05）无显著相关;两组血清BDNF水平与年龄（r=-0．142,r=-0．122;P〉0．05）、体质量指数（r=-0．112,r=0．039;P〉0．05）均无显著相关。结论：首发精神分裂症患者可能存在血清BDNF水平低下,利培酮治疗可提高其血清BDNF水平。     

精神分裂症患者机体抗氧化功能指标的实验研究

目的 探讨机体抗氧化能力在精神疾病发病机理中的作用及其临床意义。方法 采用化学比色法检测176例精神分裂症患者血清中SOD、MDA、GSH－Px、VC、VE和NO含量。结果 精神分裂症患者血清中SOD、MDA、NO含量均高于对照组（P＜0．05或0．01）;GSH－Px、VC含均低于对照组（P＜0．01）;VE两者无显著差异（P＞0．05）;精神分裂症家族史阳性者血清中NO高于精神分裂症阴性家族史者（P＜0．05）;精神分裂症患者抗氧化能力含量可因病程、性别、年龄的不同而不同;精神分裂症患者治疗后SOD、MDA低于治疗前（P＜0．01）。结论 精神分裂症患者体内自由基代谢异常可能是精神分裂症发病的生物学因素之一。     

急性发作精神分裂症患者血清前炎性因子与临床特征的关系

目的分析血清前炎性因子水平与急性发作精神分裂症患者临床特征间的关系,探索前炎性因子在疾病发生机制中可能的作用。方法共纳入急性发作的精神分裂症患者105例（患者组）,健康对照50名（对照组）。采用酶联免疫（ELISA）法检测所有研究对象血清IL-1B、IL-6和TNF—的浓度;使用阳性和阴性症状量表（PANSS）评定患者的精神病理症状。在比较患者组与对照组血清前炎性因子浓度差异的同时,分析其与患者临床特征的关系。结果（1）患者组与对照组相比,血清IL-1β[12.3（2．8,15．0）ng／L比7．9（1．3,9．9）ng／L]、TNF—α[151．6（58．9,186．8）ng／L比108．9（37．0,132．3）ng／L]的差异有统计学意义（P〈0．05）;（2）按照性别、发作次数、病程、家族史、精神病理症状对患者组进行分层,首发患者血清IL－1β、TNF－α[水平高于复发患者;病程小于5年患者血清TNF－α水平高于病程超过5年的患者;家族史阳性患者IL－6水平高于阴性患者;以阳性症状为主患者的TNF—α水平高于以阴性症状为主的患者,差异均有统计学意义（P〈0．05）;（3）患者组血清IL－1β与IL－6（r=0．49,P〈0．01）、TNF－α（r=0．30,P〈0．01）呈正相关;对照组血清IL－1β水平与IL－6（r=0．55,P〈0．01）、TNF—α（r=0．34,P=0．02）呈正相关。结论急性发作的精神分裂症患者存在免疫激活,免疫激活程度与疾病的临床特征有关;免疫异常可能在疾病发生过程中起关键作用。     

精神分裂症首次发病患者弓形虫感染率及其对临床症状的影响

目的探讨弓形虫感染与精神分裂症发病的关系，调查精神分裂症首次发病（以下简称首发）患者及其母亲弓形虫抗体阳性率，了解弓形虫抗体阳性与阴性患者在临床症状上的异同。方法采用酶联免疫吸附法，检测600例首发精神分裂症患者（患者组）、252例患者的母亲（患者母亲组）、正常对照组（200名）和非精神疾病的疾病对照组（200例）血清弓形虫抗体水平，并对患者组进行阳性和阴性症状量表评定。结果（1）IgG和IgM抗体阳性率，患者组分别为13．7％和5．3％，高于合并对照组（即正常对照组合并疾病对照组；分别为3．8％和2．8％；P〈0．01和P〈0．05）；患者母亲组分别为19．4％和9．1％，高于患者组和合并对照组（P〈0．01和P〈0．05）。（2）弓形虫抗体阳性组患者的母亲IgG和IgM抗体阳性率分别为34．8％和17．4％，高于阴性组患者的母亲（分别为16．0％和7．3％；P〈0．01和P〈0．05）。（3）阳性组患者在兴奋、敌对、装相和作态、意志障碍、冲动控制障碍、愤怒、延迟满足困难等项目的得分均高于阴性组（P〈0．01），猜疑／被害得分低于阴性组（P〈0．01）。（4）阳性组患者病程的中位数和四分位数（P25，P75）分别为3（1，9）个月，短于阴性组患者4（2，10）个月（P〈0．05）。结论弓形虫感染在首发精神分裂症患者中占有一定的比例，且弓形虫感染阳性患者的临床表现不同于未感染者，弓形虫感染可能与精神分裂症的发病有关。     

偏头痛患者血清肿瘤坏死因子的检测及其意义

通过检测偏头痛患者血清中肿瘤坏死因子α（tumornecrosisfac－tor－α,TNF－α）的含量,探讨其与偏头痛发病的关系。方法　50例病程1年以上、无用激素及免疫抑制剂的偏头痛患者和20例神经衰弱患者及20名正常对照者抽血后,用放射免疫分析法测定血清中TNF－α的含量。结果　　偏头痛患者血清中TNF－α水平显著高于神经衰弱患者（P＜0．01）及正常对照组（P＜0．01）;偏头痛患者发作期血清TNF－α水平高于间歇期（P＜0．05）;有先兆偏头痛患者与无先兆患者血清TNF－α水平差别不显著（P＞0．05）;女性偏头痛患者血清TNF－α水平高于男性（P＜0．05）;不同年龄段患者血清TNF－α水平无差别（P＞0．05）。结论TNF－α与偏头痛发病有关系,可能是引起偏头痛发作的原因。     

不同年龄的男性精神分裂症患者血清中睾酮浓度比较结果

目的：探讨不同年龄的男性精神分裂症患者血清中睾酮浓度的差异。方法：将175例男性精神分裂症患者按年龄分为老,中,青三个组,测定其血清总睾酮水平和性激素结合球蛋白浓度,计算出血清游离睾酮水平,然后与190例正常受试者进行比较。结果：与对照组相比,男性精神分裂症患者青年组血清睾酮水平无差异（P＞0．05）,而中,老年组血清睾酮水平则显著降低（P＜0．05,P＜0．01）。研究组血清睾酮水平均随年龄升高而下降,并较对照组显著（P＜0．01）,结论：不同年龄的男性精神分裂症患者血清中睾酮水平低于同龄的正常男性。     

精神分裂症患者氯丙嗪治疗前后血小板聚集功能观察

为探讨精神分裂症患者血小板聚集功能及氯丙嗪治疗对血小板聚集功能的影响,对33例首次住院的男性精神分裂症患者氯丙嗪治疗前后进行BPRS评定及肾上腺素致聚下的血小板聚集功能检测,并与60名正常对照组比较。结果显示,精神分裂症患者血小板1分钟聚集率（PAR1）、5分钟聚集率（PAR5）和最大聚集率（PARM）显著高于对照组（P＜0．05－0．01）;用氯丙嗪治疗1个月后,患者临床症状缓解,BPRS评定分值下降（P＜0．01）,血小板聚集功能PAR1无显著性改变（P＞0．05）,PAR5、PARM明显升高（P＜0．05）。提示,精神分裂症患者血小板聚集功能增强,氯丙嗪治疗可导致血小板的激活状态。     

多巴胺D3受体基因多态性与精神分裂症及其亚型的关联分析

目的：探讨精神分裂症及其亚型与多巴胺D3受体（DRD3）基因Ser9Gly多态性之间的关联。方法：使用病例－对照的关联分析方法，对528例中国汉族精神分裂症患者及241名正常对照者DRD3的多态性进行检测，并进行关联分析。结果：精神分裂症患者Gly9Gly基因型及Gly9等位基因明显高于对照组（患者组及对照组Gly9Gly基因分别为8．5％及4．6％，P＝0．053；Gly9等位基因频率分别为28．4％及23．0％，P＜0．05）；且首次发病为阳性症状者与对照组之间的等位基因的差异也有显著性（Gly9等位基因频率分别为28．6％及23．0％，P＜0．05，OR＝1．337，95％CI＝1．020－1．752）。结论：DRD3基因Ser9Gly多态性与精神分裂症整体存在显著性关联，尤其是与首次发病以阳性症状为主者关系密切。     

The effects of clozapine on cognitive function and regional cerebral blood flow in the negative symptom profile schizophrenia

OBJECTIVE: Cognitive function and regional cerebral blood flow (rCBF) were studied in negative symptom profile schizophrenic patients by using WCST and SPECT. METHODS: Twenty-one schizophrenic patients who matched the criteria of Andreason's negative symptom profile received SPECT and WCST, and then were treated with clozapine for 8 consecutive weeks. There were 28 and 12 normal subjects as the control groups of WCST and SPECT, respectively. RESULTS: Compared with controls, significantly poorer performance on total trials of category (TT), persevering errors (PE), and non-persevering errors (NPE) of WCST were found in schizophrenia (p < 0.05). The total score of the scale for assessment negative symptoms (SANS) was significantly related with poor TT (r = 0.45, p < 0.01) and PE performance (r = 0.45, p < 0.01). The poor TT, PE, and NPE tasks of WCST and SANS scores in the negative schizophrenic patients were significantly improved through clozapine treatment (p < 0.05). The schizophrenic patients had a significantly lower rCBF in bilateral frontal and temporal lobes and lower change rate of rCBF in bilateral frontal lobes during WCST compared to normal controls (p < 0.05). CONCLUSIONS: Negative symptom profile schizophrenia has cognitive deficits and lower rCBF in bilateral frontal and temporal lobes, which suggests that negative symptom profile schizophrenic patients have hypofrontality. Clozapine can improve negative symptoms and improve cognitive dysfunction, although it cannot improve reduced rCBF in the frontal lobes.     

动脉粥样硬化性血栓性脑梗死急性期血清新蝶呤动态研究

目的:探讨动脉粥样硬化性血栓性脑梗死(ATCI)急性期患者血清新蝶呤(Npt)浓度的动态变化。方法:以20例ATCI急性期患者为实验组,于发病第1、3、7、14天4个时间点分别测定血清Npt水平;以15例非血管病的神经性疾病患者为阳性对照组及20例健康体检者为正常组分别于上述时间点测定血清Npt水平。结果:ATCI急性期患者血清Npt水平于发病第1、3、7天明显高于同期阳性对照组及正常组水平(P<0.05);且发病第1、3、7天明显高于第14天水平(P<0.05)。结论:ATCI急性期血清Npt明显升高,随着病情逐渐稳定而下降,并于第14天趋于正常,反映了不稳定脑动脉粥样硬化斑块的活动情况,表明Npt是ATCI活动的一个重要标志。     

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。     

Elevated interleukin-2, interleukin-6 and interleukin-8 serum levels in neuroleptic-free schizophrenia: association with psychopathology

Cytokines have been one of the recent focal points of immunological research in schizophrenia. The present study was to assess the serum levels of some of interleukins in schizophrenia and their relationships with the psychopathological parameters. Seventy physically healthy Chinese patients, who met DSM-III-R criteria for schizophrenia and who were drug-free for at least 2 weeks, were compared with 30 age- and sex-matched Chinese normal controls. The psychopathology of schizophrenia was assessed by the Positive and Negative Syndrome Scale (PANSS). Serum levels of IL-6 and IL-8 were measured by sandwich enzyme-linked immunosorbent assay (ELISA), and serum IL-2 level was assayed by radioimmunometric assay (RIA). Serum levels of IL-2, IL-6 and IL-8 were significantly elevated in patients with a chronic form of schizophrenia (all p<0.05). There was a significant inverse relationship between IL-2 level and the PANSS positive subscale P (r=-0.31, p=0.006) and a significant positive correlation between IL-8 level and PANSS negative subscale N (r=0.25, p=0.036) in schizophrenic patients. In control subjects, a significant and positive relationship between serum IL-2 and IL-6 (r=0.513, p=0.004) was noted, whereas, there was a significant and negative relationship between IL-2 and IL-8 in schizophrenic patients (r=-0.28, p=0.02). Our data confirms and supports the view that immune disturbance is involved in schizophrenia, which is compatible with the possibility that Chinese schizophrenic patients have an ongoing autoimmune process. This immune disturbance is related to the subgroup of schizophrenic patients with characteristic clinical variables. The dysfunction of interaction or inter-adjustment between different cytokines may exist in schizophrenic patients.     

氯氮平对精神分裂症血清IL-2、IL-6的影响及临床意义

目的探讨氯氮平对精神分裂症患血清白介素-2（IL-2）、白介素-6（IL-6）水平的影响及与精神症状、体型指数变化的关系。方法选择住院的符合中国精神障碍分类与诊断标准第3版精神分裂症诊断标准的病人35例，阳性与阴性症状量表（PANSS）评分≥60分，予氯氮平治疗10周，分别于治疗前及治疗第10周末采用PANSS评估精神症状，采用酶联免疫吸附法（ELIAS）测定血清IL-2、IL-6水平。同时记录体型指数（BMI）。选取健康志愿35例作对照组，样本采集与检测同患组。结果治疗前精神分裂症患组血清IL-2水平显高于对照组（t=2．93，P=0．006），IL-6水平与对照组比较无显差异（P〉0．05）；氯氮平治疗10周末血清IL-2水平比治疗前显下降（t=3．51，P=0．001）;血清IL-6水平与治疗前相比显增高（t=2．53，P〈0．05）。治疗后精神分裂症患组体型指数显高于治疗前（t=6．02，P〈0．01）。治疗前血清IL-2水平与阳性症状评分呈显正相关（r=0．36，n=35，P=0．042）。与阴性症状、一般病理性症状、PANSS总分及体型指数均无显相关性（P〉0．05）。治疗前血清IL-6水平与各组精神症状及体型指数均无显相关性（P〉0．05）。治疗后血清IL-2下降值与阳性症状减分值呈显正相关（r=0．35，n=35，P=0．042）；IL-6增加值与各组精神症状减分值及体型指数增加值均无显相关性（P〉0．05）。结论氯氮平对精神分裂症患血清IL-2、IL-6水平有显影响，其临床意义可能与精神症状的变化有关，与氯氮平引起的体型指数变化无关。     

Perseveration and over-switching in schizophrenia

Perseveration and switching in positive and negative schizophrenic patients are usually seen as manifestations of attention disorders. They may be closely related to each other, but have not been investigated in an integrated fashion. Such integrated investigation could contribute to the neurophysiological understanding of the relationship between the regional and the pharmacological deficit in schizophrenia. This study has developed a new tool-the Combined Attention Test (CAT)-for the simultaneous measuring of perseveration and switching. Forty-one unmedicated schizophrenic patients were tested. Using the Positive and Negative Sorting Scale (PANSS), subjects were classified into the two experimental groups: positive and negative schizophrenics. The control group consisted of 24 healthy subjects. Schizophrenic patients with positive symptoms tended to switch more than schizophrenic patients with negative symptoms and normal subjects; schizophrenic patients with negative symptoms tended to perseverate more than schizophrenic patients with positive symptoms and normal subjects. Over-switching is discussed as a specific symptom related to positive schizophrenia.     

稳定期精神分裂症患者血浆炎症因子与症状相关性研究

目的探讨稳定期精神分裂症患者血浆炎症因子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(研究组)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)检测所有被试的血浆促炎因子肿瘤坏死因子α(tumor necrosis factorα,TNF-α)和抗炎因子白介素10(interleukin 10,IL-10)浓度,采用阳性与阴性症状量表(positive and negative symptom scale,PANSS)评估患者临床症状。结果研究组与对照组的促炎因子TNF-α浓度差异有统计学意义[中位数与上下四分位数:1.16(1.02,1.49)ng/L vs.0.67(0.61,0.76)ng/L,P<0.01],IL-10浓度差异无统计学意义(P>0.05)。偏相关分析示,研究组血浆TNF-α浓度与PANSS中反应缺乏因子(r′=-0.33,P=0.01)、偏执因子(r′=-0.32,P=0.01)之间呈负相关。结论稳定期精神分裂症患者血浆TNF-α水平高于正常对照水平,且患者TNF-α水平与临床症状严重程度存在一定联系。     

Associations of serum brain-derived neurotrophic factor with cognitive impairments and negative symptoms in schizophrenia

Brain-derived neurotrophic factor (BDNF) may be involved in the pathophysiology of schizophrenia. The aim of this study was to examine the associations of serum BDNF levels with the cognition and clinical characteristics in patients with schizophrenia. Sixty-three patients with schizophrenia and 52 age- and sex-matched healthy controls were examined with neuropsychological tests. Serum BDNF levels were determined by enzyme-linked immunosorbent assay (ELISA). There were no significant differences in serum BDNF levels between normal controls and patients with schizophrenia. Serum BDNF levels of normal controls showed negative correlations with verbal working memory, but this was not the case with schizophrenic patients. Meanwhile, serum BDNF levels of schizophrenic patients showed positive correlations with the scores of the Scale for the Assessment of Negative Symptoms (SANS) and the Information subtest scores of Wechsler Adult Intelligence Scale Revised (WAIS-R). Serum BDNF levels are related with the impairment of verbal working memory and negative symptoms in patients with schizophrenia.     

精神分裂症记忆与阳性、阴性症状的研究

目的探讨精神分裂症患者记忆特点及与阳性、阴性症状的关系。方法采用修正的加工分离记忆实验程序测试精神分裂症患者记忆变化情况,用PANSS评定精神分裂症患者阳性、阴性症状分。结果精神分裂症外显记忆与对照组比较明显受损(P0.05),其文字概念和图像概念实验类型驱动的内隐记忆成绩与对照组比较也受损(P0.05);阳性症状为主的患者外显记忆成绩均高于阴性症状为主的患者组(P0.05);阳性症状为主的患者内隐记忆成绩与以阴性症状为主的患者组之间的差异无统计学意义(P0.05);阳性症状与外显记忆无显著相关关系(P0.05),阴性症状与外显记忆呈显著负相关关系(P0.01);阳性症状、阴性症状与内隐记忆均无显著相关关系(P0.05)。结论精神分裂症外显记忆严重受损,而内隐记忆不同程度的受损;外显记忆与阳性症状无相关性,与阴性症状有显著相关;内隐记忆与阳性、阴性症状均无明显相关性。     

Heart rate dynamics and their relationship to psychotic symptom severity in clozapine-treated schizophrenic subjects

The analysis of heart rate variability (HRV) has proven to be useful in evaluating the neuroautonomic dysfunctions associated with various clinical conditions. The purpose of this study was to investigate the linear and non-linear dynamic measures of HRV, and to evaluate their relationship with the psychotic symptom severity, in clozapine-treated schizophrenic subjects. Fifty schizophrenic patients treated with clozapine as monotherapy and 50 normal control subjects were evaluated for HRV analysis. The HRV measurements were obtained from a 30-min resting electrocardiogram (ECG). The severity of psychotic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). In the patient group, the complexity and symbolic dynamics measures as well as the time and frequency domain measures of HRV were significantly lower than in the control group (P<0.01). The intermediate-term fractal scaling component value was significantly higher in the patient group (P<0.01). The PANSS total score and the positive symptom subscale score had significant negative correlations with the sample entropy (SampEn) value (P<0.01). In conclusion, schizophrenic patients treated with clozapine had markedly different heart rate dynamics compared to normal control subjects. The severity of psychotic symptoms was associated with the SampEn value, suggesting that the non-linear complexity measure might be useful in assessing the neuroautonomic dysfunction in schizophrenia.