系统性红斑狼疮患者治疗前后血清TNF-α、IL-6和sIL-2R水平变化及临床意义

目的:探讨系统性红斑狼疮( SLE)患者治疗前后肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和可溶性白细胞介素-2受体(sIL-2R)的水平变化及对免疫功能的影响。方法:采用固相酶标记化学发光免疫分析技术检测40例SLE患者激素治疗前后血清TNF-α、IL-6和sIL-2R水平,应用免疫速率散射比浊法测定免疫球蛋白G(IgG)和补体3(C3)水平。以30例体检正常者作对照。结果:40例SLE患者治疗前活动期血清IgG、TNF-α、IL-6和sIL-2R水平明显高于正常对照组,而C3水平明显低于正常对照组,均P0.01。经激素治疗后(稳定期),SLE患者血清IgG、TNF-α、IL-6和sIL-2R水平显著下降,C3显著升高,均P0.01,但IgG、C3、TNF-α和IL-6水平仍与正常对照组有显著统计学差异(P0.01)。结论:SLE患者TNF-α、IL-6和sIL-2R表达增加,提示SLE的发病过程涉及免疫紊乱和细胞因子失平衡。     

精神分裂症患者血浆炎性因子水平变化及与临床症状严重程度的相关性

目的:探讨首发精神分裂症患者和复发精神分裂症患者急性发作时血浆细胞因子水平及其与临床症状的关系。方法:本研究纳入首发精神分裂症急性期患者33例(首发组)、复发精神分裂症急性发作期患者35例(复发组)及健康对照组32例(对照组)。采用流式免疫技术检测被试者血浆中炎性因子水平,采用阳性与阴性症状量表(PANSS)评估患者临床症状严重程度。比较各组以上指标水平的差异,同时分析炎性因子水平与精神分裂症患者临床症状严重程度的关系。结果:与对照组相比,首发组和复发组血浆中白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)水平均显著升高(P<0.01)且复发组IL-6较首发组升高更明显(P<0.01),各组白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α),干扰素-γ(IFN-γ)水平差异无统计意义(P>0.05)。另外,首发组和复发组血浆中IL-2与PANSS总分、阳性症状量表、一般精神病理症状量表评分呈正相关(r=0.26,P<0.05;r=0.25,P<0.05;r=0.35,P<0.01);IL-10与阴性症状量...     

新生儿感染性疾病IL-6、IL-8和TNFα的研究

目的分析比较新生儿感染性疾病(败血症与一般感染)血浆中细胞因子直接及诱生水平的变化特征.方法采用双抗体夹心酶联免疫吸附实验法(ELISA)测定白细胞介素6(IL-6)、白细胞介素8(IL-8)和肿瘤坏死因子α(TNFα)的水平 .结果入院时败血症、一般感染患儿血浆IL-6、IL-8、TNFα直接水平显著高于各自恢复期(P<0.05),败血症患儿三者极显著高于健康对照组(P<0.01),一般感染患儿三者显著高于健康对照组(P<0.05).两组恢复期三者与健康对照组无显著性差异(P>0.05),入院时败血症三者显著高于一般感染患儿(P<0.05).结论新生儿血浆中高水平的IL-6、IL-8和TNFα提示机体存在感染,可做为早期诊断的灵敏指标,并与感染轻重程度有关,还可做为判断疗效的指标.     

肾移植受者血清TNF-α、IL-6和sIL-2R水平变化及临床意义

目的:探讨肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和可溶性白细胞介素-2受体(sIL-2R)在肾移植术后急性排斥反应中的变化。方法:采用固相酶标记化学发光免疫分析技术动态监测36例患者肾移植前后血清TNF-α、IL-6和sIL-2R水平,并结合临床资料作全面分析。结果:肾移植受者术后第1天血清TNF-α、IL-6和sIL-2R均明显升高,其中移植稳定组血清IL-6和sIL-2R第1天出现峰值后开始下降,而TNF-α则在术后5天达峰值后开始下降,至第10天均接近术前水平。急性排斥组血清TNF-α、IL-6和sIL-2R水平与肾功能稳定组比较,差异有显著性(P<0.05),抗排斥治疗有效后迅速下降。而环孢素A中毒组与稳定组比较,差异无显著性(P<0.05)。结论:肾移植术后受者血清TNF-α、IL-6和sIL-2R水平的检测,可在一定程度上反映肾移植受者的免疫反应状态,并为急性排斥反应的监测和诊断提供客观依据。     

首发精神分裂症偏执型患者血浆中IL-2、IgG变化的研究

目的 研究首发精神分裂症偏执型患者血浆中白细胞介素—2(IL-2)、免疫球蛋白G(IgG)的变化。方法 病例组为住院的符合中国精神疾病诊断标准及分类方案第3版首发精神分裂症偏执型诊断标准病人30例，PANSS量表评分大于等于60分；选取正常对照组20例对照，采用酶联免疫吸附法和速率散射比浊法分别测定对照组和精神分裂症治疗前及治疗后6周IL—2、IgG血浆浓度，并进行组间比较。结果 精神分裂症组治疗前血浆IL—2、IgG的水平显著增高，与对照组比较差并有显著性(P＜0．05)；精神分裂症组治疗6周症状基本缓解后，血浆IL—2水平与对照组比较差异无显著，性(P＞0、05)、IgG的水平校对照组显著增高(P＜0．05)；症状基本缓解后血浆IL—2水平较治疗前有显著下降(P＜0、05)，IgG水平治疗后较治疗前在统计学上无显著差异(P＞0．05)。结论 精神分裂症患者有免疫功能紊乱，治疗后IL-2水平下降也许可以作为精神病药物影响免疫变化的一个指标。     

充血性心力衰竭患者血浆TNF-α、IL-1β 和IL-6含量变化

目的检测充血性心力衰竭(CHF)患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)水平,了解这些细胞因子在CHF过程中的可能作用。方法取20例正常人和20例Ⅱ°-Ⅲ°CHF患者静脉血,用ELISA法测血清TNF-α、IL-1β和IL-6含量。结果CHF组这些细胞因子水平均明显高于对照组(P＜0.01);CHF程度越重,这些细胞因子浓度越高;TNF-α与IL-1β和IL-6含量之间呈正相关(r=0.9684,0.9768;P均＜0.01)。结论细胞因子TNF-α、IL-1β和IL-6可能参与CHF过程。     

抗精神病药物对儿童少年精神分裂症患者血浆白细胞介素-6的影响

目的探讨抗精神病药物对儿童少年精神分裂症患者白细胞介素-6(IL-6)的影响及IL-6与精神病理的关系。方法对41例儿童少年首发精神分裂症患者用酶联免疫吸附法检测抗精神病药物治疗前后IL-6血浆水平,用健康儿童少年作对照,并用阳性和阴性症状量表(PANSS)评估精神症状及其变化。结果治疗前患者组血浆IL-6水平显著高于正常对照组,治疗后4、8周末IL-6水平显著低于治疗前。治疗后4周末IL-6水平与阳性症状呈正相关,治疗后4、8周末一般病理分减分率、治疗后8周末PANSS总分减分率与IL-6减分率呈正相关。结论儿童少年精神分裂患者存在细胞免疫异常,抗精神病药物对儿童少年精神分裂症患者有免疫抑制作用,血浆IL-6与精神分裂症精神病理之间有一定的关系。     

抗甲状腺药物影响Graves’病患者外周血细胞因子水平的表达

目的：研究抗甲状腺药物对Graves’病（GD）患者血清细胞因子水平的影响。方法：用放射免疫分析检测30例GD患者抗甲状腺药物治疗前后血清白细胞介素-2（IL-2）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平,30例年龄与性别相匹配的健康者作为正常对照组。结果：GD患者血清IL-6、TNF-α水平显著高于正常对照组（P〈0.01）,IL-2显著低于正常对照组（P〈0.01）;抗甲状腺药物治疗,甲状腺功能恢复正常后,IL-2明显升高,与正常对照组比较差异无显著性（P〉0.05）;IL-6、TNF-α明显低于治疗前（P〈0.01）,但仍高于正常对照组（P〈0.05）。结论：抗甲状腺药物治疗前后血清细胞因子水平的变化可能与发病机制、治疗效果和预后有关。     

急性早幼粒细胞白血病患者诱导分化治疗前后血清IL-2受体的变化及意义

ELISA 法检测27例急性早幼粒细胞白血病患者(APL)血清白细胞介素2受体(sIL-2R)水平.结果表明APL 患者血清sIL-2R 高于正常对照(P<0.01),经维甲酸治疗后逐渐降低,但治疗中期患者血清sIL-2R 仍高于正常和治疗后(缓解期)患者血清sIL-2R(P<0.05)。治疗后血清sIL-2R 虽略高于正常对照。却已恢复正常范围(P<0.05)。同时发现治疗中WBC 却明显升高,治疗后又下降,L-CFU 数随治疗逐渐降低并与病情同步变化。经相关分析,L-CFU 与血清sIL-2R 成正向相关(r=0.737)(P<0.01),而与WBC总数无明显相关性(P>0.05)。     

Graves’眼病患者血清IL-2、sIL-2R和TGF-β测定的临床意义

目的：探讨Graves’眼病患者血清IL-2、sIL-2R和TGF-β水平的变化、病情进展和病因学的关系。方法：对照组30名和Graves眼病30例患者的血清TGF-β含量均采用放射免疫分析;血清IL-2、sIL-2R均采用酶联免疫吸附试验。结果：30例Graves’眼病患者血清IL-2治疗前水平非常显著低于对照组（P〈0.01）;经免疫抑制剂治疗6个月后水平较治疗前升高非常显著,与对照组比较已无显著性差异（P〉0.05）;sIL-2R含量治疗前非常显著的高于治疗后组和对照组（P〈0.01）;经用上述方案治疗后与对照组比较下降非常显著,但仍存在显著性差异（P〈0.05）;血清TGF-β浓度在治疗前非常显著地高于对照组（P〈0.01）;经治疗后显著下降,但与对照组比较差异仍非常显著（P〈0.01）。结论：Graves’眼病患者血清IL-2、sIL-2R和TGF-β三项血清指标的测定对于了解和认识其发病机理及预估病情有帮助。     

Seasonality of symptom onset in first-episode schizophrenia

BACKGROUND: There have been numerous reports of seasonal trends in psychotic illnesses. In schizophrenia, seasonal trends in incidence have been shown to be especially apparent in first-episode cases. Most previous research has used date of admission as a proxy for date of incidence of disorder; we present results of an investigation into seasonal trends in dates of onset of symptoms in a group of 295 first-episode cases of schizophrenia and schizophreniform disorder. METHOD: Data were analysed using statistical methods appropriate for detecting seasonal trends in pooled data over 6 years. RESULTS: Only male cases of schizophrenia and schizophreniform disorder showed a significant seasonal distribution to dates of onset of symptoms, with a peak in August (winter). CONCLUSION: True seasonal patterns are present in schizophrenia incidence, but their consistency with other published studies and wider significance, is difficult to ascertain because of different methods used in dating incidence of disorder.     

首发精神分裂症患者血浆非酶抗氧化物浓度与临床特征

目的:探讨在首发精神分裂症患者中血浆非酶抗氧化物浓度与临床特征的关系。方法:选择符合国际疾病分类第十版(ICD-10)的精神分裂症诊断标准首发患者64例,作为病例组(包括家族史阳性30例,阴性34例)和42名健康成人作为对照组,分别测定血浆白蛋白、总胆红素和尿酸浓度。病例组采用阳性和阴性症状量表(PANSS)评定精神病理症状。结果:病例组血浆白蛋白和尿酸浓度低于对照组(P均<0.05);家族史阳性患者白蛋白和胆红素浓度低于家族史阴性患者(P均<0.05);家族史阳性患者病程与尿酸浓度呈负相关(r=-0.50,P<0.05),阴性症状分与白蛋白和尿酸浓度呈负相关(r=-0.37,-0.41,P<0.05)。结论:精神分裂症首发患者血浆非酶抗氧化能力下降,而且可能与阴性症状、家族史有关。     

Naturalistic follow-up of co-morbid substance use in schizophrenia: the West London first-episode study

BACKGROUND: The impact of co-morbid substance use in first-episode schizophrenia has not been fully explored. METHOD: This naturalistic follow-up of a cohort of 152 people with first-episode schizophrenia examined substance use and clinical outcome in terms of symptoms and social and neuropsychological function. RESULTS: Data were collected on 85 (56%) of the patient cohort after a median period of 14 months. Over the follow-up period, the proportion of smokers rose from 60% at baseline to 64%. While 30% reported lifetime problem drinking of alcohol at baseline, only 15% had problem drinking at follow-up. Furthermore, while at baseline 63% reported lifetime cannabis use and 32% were currently using the drug, by the follow-up assessment the latter figure had fallen to 18.5%. At follow-up, persistent substance users had significantly more severe positive and depressive symptoms and greater overall severity of illness. A report of no lifetime substance use at baseline was associated with greater improvement in spatial working memory (SWM) at follow-up. CONCLUSIONS: Past substance use may impede recovery of SWM performance in people with schizophrenia in the year or so following first presentation to psychiatric services. The prevalence of substance use other than tobacco tends to diminish over this period, in the absence of specific interventions. Persistent substance use in first-episode schizophrenia is associated with more severe positive and depressive symptoms but not negative symptoms, and should be a target for specific treatment intervention.     

首发精神分裂症患者抑郁症状9年随访

目的:探讨首发精神分裂症病人接受抗精神病药物治疗后9年中抑郁症状的转归及与其他相关因素的关系。方法:本研究纳入符合中国精神疾病分类方案与诊断标准第二版修订本(CCMD-2-R)精神分裂症诊断标准的164例首次发病住院患者,用汉密尔顿抑郁量表(HAMD)、简明精神病评定量表(BPRS)、阴性症状量表中文版(SANS-CV)、临床总体印象量表(CGI)及功能总体评定量表(GAF)对患者在入院时及治疗后9年中每年进行一次评定,并据此计算缓解时间。结果:共139例患者完成随访。从治疗后的第1年起,每年末HAMD总分≥8分的患者所占比例为3.6%～13.7%,治疗后1～9年的HAM D总分均低于入院水平(P0.001)。入组时HAM D总分与治疗后9年中的缓解时间、9次年末的去除焦虑抑郁因子BPRS总分、SANS-CV、CGI及GAF分均无统计学意义相关。结论:经抗精神病药治疗1年之后,首发精神分裂症患者急性期的抑郁症状迅速减轻,此后在较低水平上略有波动;急性期抑郁症状水平不能预测精神分裂症的长期预后。     

首发精神分裂症女性患者雌激素与事件相关电位的相关性

目的：研究首发精神分裂症女性患者雌激素与事件相关电位（ERP）P300的关系。方法：采用放射免疫法测定30例首发精神分裂症女性患者（患者组）与20名正常女性（对照组）的血清雌激素水平;并用ERPP300（即P3波）评定患者认知功能。结果：①患者组雌二醇（E2）水平低于对照组,差异有统计学意义（P〈0．05）;②与正常对照组比较,患者组靶刺激N1、N2和P3波及非靶刺激P2波潜伏期延迟,靶刺激P3波及非靶刺激P2波波幅降低;③患者组E2水平与P300潜伏期呈显著负相关（r=-0．43,P=0．02）。结论：首发精神分裂症女性患者存在雌激素水平下降,以及注意力、记忆力缺陷和认知加工缓慢等认知障碍,雌激素水平与认知功能呈显著相关。     

Right lateralized white matter abnormalities in first-episode,drug-naive paranoid schizophrenia

Numerous studies in first-episode schizophrenia suggest the involvement of white matter (WM) abnormalities in multiple regions underlying the pathogenesis of this condition. However, there has never been a neuroimaging study in patients with first-episode, drug-naive paranoid schizophrenia by using tract-based spatial statistics (TBSS) method. Here, we used diffusion tensor imaging (DTI) with TBSS method to investigate the brain WM integrity in patients with first-episode, drug-naive paranoid schizophrenia. Twenty patients with first-episode, drug-naive paranoid schizophrenia and 26 healthy subjects matched with age, gender, and education level were scanned with DTI. An automated TBSS approach was employed to analyze the data. Voxel-wise statistics revealed that patients with paranoid schizophrenia had decreased fractional anisotropy (FA) values in the right superior longitudinal fasciculus (SLF) II, the right fornix, the right internal capsule, and the right external capsule compared to healthy subjects. Patients did not have increased FA values in any brain regions compared to healthy subjects. There was no correlation between the FA values in any brain regions and patient demographics and the severity of illness. Our findings suggest right-sided alterations of WM integrity in the WM tracts of cortical and subcortical regions may play an important role in the pathogenesis of paranoid schizophrenia.     

Resting EEG in first-episode and chronic schizophrenia

We examined the frequency characteristics of the electroencephalogram (EEG) in 102 schizophrenic patients (44 first-episode and 58 chronic patients) and 102 normal comparison subjects. EEGs of schizophrenic patients had more delta (1–3 Hz) and theta (3.125–8 Hz) activity and less alpha (8.125–13 Hz) activity than normal comparison subjects. There were no significant differences in the EEG frequency composition of first-episode and chronic patients. Because first-episode and chronic patients were characterized by different disorder durations and treatment histories, the similarity of their EEGs suggests that EEG abnormalities are stable characteristics of schizophrenia and are not treatment-related epiphenomena. A principal components analysis of EEG power bands identified an augmented low frequency-diminished alpha component and a beta component. Schizophrenic patients had significantly higher scores on the augmented low frequency-diminished alpha component than did normal comparison subjects, and there was no significant group difference in scores on the beta component. The findings of this investigation suggest that EEG abnormalities in schizophrenia reflect aspects of brain dysfunction.     

不同性别首发精神分裂症患者听觉事件相关电位的研究

目的 研究不同性别首发精神分裂症患者听觉事件相关电位(ERP)是否存在差异,并分别探讨两组事件相关电位与临床阴性、阳性症状的关系.方法 对60例(男32例,女28例)首发神分裂症患者及30例正常人进行事件相关电位检测,并运用阳性和阴性症状量表进行精神症状评定.结果 ①两患者组的N2、P3潜伏期明显长于对照组,P3波幅明...     

Association of biomarkers and depressive symptoms in schizophrenia

Emergence of depressive symptoms in schizophrenia results in a deteriorating course and poor prognosis. Schizophrenia and depressive disorder are both associated with low levels of brain-derived neurotrophic factor (BDNF) and with a longstanding low grade inflammatory state. The objective of this study is to analyze the relationship between these serum biomarkers and depressive and psychotic symptoms in schizophrenic patients. Thirty-nine individuals diagnosed with schizophrenia or schizoaffective disorder by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), assessed by Structured Clinical Interview for DSM-IV (SCID), were included. Interviews were conducted with The Positive and Negative Syndrome Scale (PANSS) and The Calgary Depression Scale for Schizophrenia (CDSS). Blood samples were collected for determination of BDNF, IL-1beta, IL-6, IL-8, IL-10, IL-12 and TNF-alpha measurements. Positive correlations between BDNF and CDSS and between IL-1beta and severity in PANSS scores were found. BDNF levels were not correlated with any cytokine or with PANSS scores. The results of this study suggest that depressive and psychotic symptoms may be associated with different profiles of biomarkers in the association between schizophrenia and depression.     

Minor physical anomalies in patients with first-episode psychosis: their frequency and diagnostic specificity

BACKGROUND: An increased prevalence of minor physical anomalies (MPAs) has been extensively documented in schizophrenia but their specificity for the disorder remains unclear. We investigated the prevalence and the predictive power of MPAs in a large sample of first-episode psychotic patients across a range of diagnoses. METHOD: MPAs were examined in 242 subjects with first-episode psychosis (50% schizophrenia, 45% affective psychosis and 5% substance-induced psychosis) and 158 healthy controls. Categorical principal components analysis and analysis of variance were undertaken, and individual items with the highest loading were tested using the chi2 test. RESULTS: Overall facial asymmetry, assymetry of the orbital landmarks, and frankfurt horizontal significantly differentiated patients with schizophrenia and affective psychosis from controls, as did a 'V-shaped' palate, reduced palatal ridges, abnormality of the left ear surface and the shape of the left and right ears. Patients with affective psychosis had significantly lowered eye fissures compared with control subjects. CONCLUSIONS: MPAs are not specific to schizophrenia, suggesting a common developmental pathway for non-affective and affective psychoses. The topographical distribution of MPAs in this study is suggestive of an insult occurring during organogenesis in the first trimester of pregnancy.