s-100β蛋白、甲状腺功能五项与精神分裂症认知功能关系及诊断效能

Relationship and diagnostic Efficacy between 4s-100 β Protein,Thyroid Function and cognitive Function in Schizophrenia

目的分析s-100β蛋白、甲状腺功能五项与精神分裂症认知功能关系及诊断效能。方法选取驻马店市第二人民医院2020年5月至2022年12月精神分裂症患者142例,均持续治疗6周,根据简易精神状态评价量表(MMSE)分为认知功能正常(25~30分,n=77例)、轻度认知功能障碍(21~24分,n=41例)、中度认知功能障碍(14~20分,n=15例)、重度认知功能障碍(≤13分,n=9例)4个亚组。比较治疗前后精神分裂症患者中枢神经特异性蛋白(s-100β)、甲状腺功能五项[总甲状腺素(TT4)、总三碘甲状腺原氨酸(TT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)],比较不同程度认知障碍患者s-100β蛋白、甲状腺功能五项水平,分析s-100β蛋白、甲状腺功能五项与MMSE评分相关性及对精神分裂症的诊断价值。结果与治疗前比较,治疗后血清s-100β蛋白、TT4、FT4水平下降,TT3、FT3、TSH水平升高,差异有统计学意义(P<0.05)。血清s-100β蛋白、TT4、FT4在认知功能正常、轻度、中度及重度认知障碍患者中呈升高趋势,FT3、TT3、TSH呈下降趋势,差异有统计学意义(P<0.05)。治疗前血清s-100β蛋白、TT4、FT4与MMSE评分呈负相关,TT3、FT3、TSH与MMSE评分呈正相关,差异有统计学意义(P<0.05)。s-100β蛋白、甲状腺功能五项联合诊断精神分裂症的受试者工作曲线ROC的曲线下面积(AUC)达0.823,大于单一血清指标诊断,差异有统计学意义(P<0.05)。结论s-100β蛋白、甲状腺功能五项与精神分裂症认知功能障碍密切相关,可作为精神分裂症诊断及疗效检测的有效生物学标志物。

Objective To analyze the relationship and diagnostic efficacy between central nervous system specific(S-100β),thyroid function and cognitive function in schizophrenia.Methods A total of 142 patients with schizophrenia were selected from the Second People's Hospital of Zhumadian City from May 2020 to December 2022,all of whom underwent continuous treatment for 6 weeks.According to the Mini Mental State Evaluation Scale(MMSE),they were divided into four subgroups:normal cognitive function(25~30 points,n=77 cases),mild cognitive impairment(21~24 points,n=41 cases),moderate cognitive impairment(14~20 points,n=15 cases),and severe cognitive impairment(≤13 points,n=9 cases).The levels of S-100βprotein and five items of thyroid function[total thyroxine(TT4),total triiodothyronine(TT3),free thyroxine(FT4),free triiodothyronine(FT3),thyroid stimulating hormone(TSH),free triiodothyronine(FT3)]in patients with schizophrenia were compared before and after treatment,the levels of S-100βprotein and five items of thyroid function in patients with different degrees of cognitive impairment were compared,and the correlation between the levels of S-100βprotein and five items of thyroid function and MMSE score was analyzed,as well as the diagnostic value for schizophrenia.Results Compared with pre-treatment,After treatment the levels of serum S-100βprotein,TT4,and FT4 decreased,while the levels of TT3,FT3,and TSH increased,with statistical significance(P<0.05).Serum S-100βprotein,TT4,and FT4 showed an increasing trend in patients with normal cognitive function,mild,moderate,and severe cognitive impairment,while FT3,TT3,and TSH showed a decreasing trend,with statistically significant differences(P<0.05).Before treatment,there is a negative correlation between serum S-100βprotein,TT4,FT4,and MMSE score,while TT3,FT3,TSH are positively correlated with MMSE score,and the difference is statistically significant(P<0.05).The area under the curve(AUC)of the ROC curve for the combined diagnosis of S-100βprotein and thyroid function in patients with schizophrenia reached 0.823,which is larger than the diagnosis of a single serum indicator,and the difference is statistically significant(P<0.05).Conclusion S-100βprotein and thyroid function are closely related to cognitive dysfunction in schizophrenia,and can serve as effective biological markers for the diagnosis and efficacy testing of schizophrenia.