Omega-3多不饱和脂肪酸对男性首发精神分裂症患者神经营养因子及临床疗效影响

目的:探讨Omega-3多不饱和脂肪酸(Ω-3 PUFAs)对男性首发精神分裂症患者血浆二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)、血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)及临床疗效的影响。方法:将100例男性首发精神分裂症患者随机分为对照组(50例)和研究组(50例)。对照组给予利培酮加安慰剂,研究组给予利培酮与1.5 gΩ-3 PUFAs,治疗16周。治疗前后测定患者EPA、DHA、NGF、BDNF水平;应用阳性和阴性症状量表(PANSS)评估精神症状,治疗中出现的症状量表(TESS)评估不良反应。结果:研究组治疗后EPA、DHA、NGF、BDNF水平较治疗前显著增高,且升高幅度显著高于对照组(P均<0.05)。两组PANSS总分、阳性症状分、阴性症状分和一般病理分较治疗前显著降低,研究组PANSS总分、阴性症状评分下降幅度显著高于对照组(P均<0.05)。DHA与PANSS总分、阴性症状分呈负相关,BDNF与PANSS阴性症状分、一般病理分呈负相关(P均<0.05)。结论:Ω-3 PUFAs联合利培酮比单用利培酮对治疗男性首发精神分裂症效果更佳,其原因可能与升高患者的DHA及BNDF水平有关。

Effects of omega-3 polyunsaturated fatty acids on neurotrophic factors and clinical efficacy in male patients with first-episode schizophrenia

Objective:To explore the effects of omega-3 polyunsaturated fatty acids(Ω-3 PUFAs)on eicosapentaenoic acid(EPA),docosahexaenoic acid(DHA),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF)and clinical efficacy in male patients with first-episode schizophrenia.Method:100 male patients with first-episode schizophrenia were randomly divided into control group(n=50)and trial group(n=50).All patients received risperidone treatment with additionalΩ-3 PUFAs 1.5 g(the trial group)or placebo(the control group)for 16 weeks.Plasma levels of EPA,DHA,BDNF and NGF of patients were determined at baseline and after treatment.The Positive and Negative Syndrome Scale(PANSS)was used to assess the change of clinical psychiatric symptoms.The adverse reactions were evaluated by Treatment Emergency Symptom Scale(TESS).Results:The levels of EPA,DHA,NGF and BDNF in the trial group were significantly higher than those in the control group(all P<0.05).After treatment,the total PANSS scores,positive symptom scores,negative symptom scores and general pathological scores in the two groups were significantly lower than before.Compared with the control group,the trial group significantly reduced the total PANSS scores and negative symptom scores more(all P<0.05).The changes of DHA had negative correlation with the change of the total PANSS scores and negative symptom scores.The changes of BDNF had negative correlation with the change of PANSS negative symptom scores and general pathological scores(all P<0.05).Conclusion:Ω-3 PUFAs combined with risperidone intervention is better than risperidone alone in the treatment of male patients with first-episode schizophrenia by elevating the DHA and BDNF levels.