精神分裂症患者血清BDNF、GDNF水平与认知功能的改变及抗精神药物和物理治疗对其的影响

目的:探讨精神分裂症患者血清脑源性神经营养因子(brain-derived neurotrophic factors,BDNF)、胶质源性神经营养因子(glial-derived neurotrophic factors,GDNF)水平、认知功能的改变及抗精神药物和物理治疗对其的影响。方法:以2013年2月-2015年6月我院收治的60例慢性精神分裂症患者(研究组)及同期于我院体检的30例健康志愿者(健康组)为研究对象,比较两组BDNF、GDNF、认知功能,将研究组患者依据治疗方式不同分为干预组(抗精神药物和物理治疗,28例)及基础组(基础药物治疗,32例),比较治疗后两组BDNF、GDNF水平、认知功能。结果:研究组BDNF、GDNF表达水平及Stroop测验、符号编码、言语记忆、工作记忆评分较健康组显著低,而连线测试评分较健康组明显高(t=-11.504,-3.613,-8.649,-5.155,-3.982,-3.260,4.701;P0.05);治疗后干预组及基础组BDNF、GDNF水平、认知功能总评分较治疗前明显升高,PANSS阳性、阴性、一般精神病理评分明显降低,且治疗后干预组的升高、降低程度较基础组显著(t=-3.908,-2.141,-5.008,-3.423,-3.064,-3.166;P0.05);受试患者血清BDNF水平与PANSS阳性评分呈负相关(r=-0.310,P0.05),而血清GDNF水平与Stroop色词干扰测验评分呈正相关(r=0.542,P0.05)。结论:精神分裂症患者血清BDNF、GDNF水平、认知功能较健康人群显著低,BDNF、GDNF在本病发生、进展及预后中发挥重要作用,而抗精神药物和物理治疗可作为精神分裂症患者首选治疗方案。

Effect of Antipsychotics and Physical Therapy on Changes of Serum BDNF,GDNF Levels and Cognitive Function in Patients with Schizophrenia

Objective:To investigate the effect of antipsychotics and physical therapy on changes of serum brainderived neurotrophic factor(BDNF),glial-derived neurotrophic factor GDNF)levels and cognitive function in patients with schizophrenia.Methods:60 patients with chronic schizophrenia(study group)and 30 healthy volunteers (healthy group)who were admitted to our hospital between February 2013 and June 2015 were enrolled in the study.The BDNF,GDNF and cognitive function were compared between the two groups.Patients in the study group were divided into the intervention group(n =28,antipsychotics and physical therapy)and the basic group(n =32,basic drugs).The levels of BDNF,GDNF and cognitive function were compared between the two groups.Results:The expression levels of BDNF and GDNF,Stroop test,symbolic coding,verbal memory and working memory scores were significantly lower in study group than the healthy group while line connection test score was significantly higher(t =11.504,3.613,8.649,5.155,-3.982,-3.260,4.701;P＜0.05).After treatment,levels of BDNF and GDNF,total scores of cognitive function in intervention group arid basic group were significantly higher than those before treatment,while PANSS positive,negative and general psychopathological scores were significantly lower,and the changes were more obvious in intervention group than basic group(t =-3.908,-2.141,-5.008,-3.423,-3.064,-3.166;P＜0.05).Serum BDNF level was negatively correlated with PANSS positive score (r =-0.310,P ＜ 0.05),while serum GDNF level was positively correlated with the Stroop Color-Word Task score(r =0.542,P＜0.05).Conclusion:The levels of serum BDNF,GDNF and cognitive function in patients with schizophrenia are significantly lower than those in healthy controls.BDNF and GDNF play an important role in the occurrence,progress and prognosis of the disease,and antipsychotics and physical therapy can be used as the preferred treatment for patients with schizophrenia.