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。

Influences of clozapine on serum levels of IL- 2 and IL 6 in schizophrenia and clinical effects

Objective To explore the influences of clozapine on serum levels of IL-2 and IL-6 in schizophrenia and the relation of psychotic symptoms and body mass index (BMI). Methods 35 inpatients whose symptoms met CCMD-3 criteria for schizophrenia and PANSS scores were no less than 60 scores were sampled. They had been treated with clozapine for 10 weeks. Before giving the treatment and at the end of tenth week after the treatment, PANSS was used to estimate their psychotic symptoms, and the levels of IL-2 and IL-6 were measured with enzyme-linked immunosorbent assay (ELISA); meanwhile, BMI was recorded. 35 healthy volunteers were enrolled as control group. Results Before the treatment, the level of IL-2 of inpatients in case group was significantly higher than that of healthy volunteers in control group (t=2.93,P=0.006), but there was no significant difference in IL-6 levels between the tow groups (P>0.05). At the end of tenth week after the treatment, the IL-2 levels decreased significantly (t=3.51,P=0.001), the IL-6 levels significantly increased (t=2.53,P<0.05) and BMI significantly increased (t=6.02,P<0.01). Before the treatment, there was a positive correlation between IL-2 level and positive symptoms (r=0.36,n=35,P=0.042), but there were no significantly correlation between IL-2 level and negative symptoms, general symptoms, total scores of PANSS and BMI (P>0.05); there was no significantly correlation among IL-6 level and any psychotic symptom and BMI (P>0.05). After the treatment, there was a significantly positive correlation between decreased IL-2 level and decreased positive symptoms (r=0.35,n=35,P=0.042); there was no significantly correlation among increased IL-6 level and decreased psychotic symptom and increased BMI (P>0.05). Conclusions There is significant influence of clozapine on serum levels of IL-2 and IL-6 and it may be relate with the change of psychotic symptoms, but it is not relate with the change of BMI which is caused by clozapine.