首发精神分裂症偏执型患者血浆及脑脊液肿瘤坏死因子α水平的研究

Study of blood plasma and cerebrospinal fluid levels of tumor necrosis factor-α in first episode paranoid schizophrenia

目的通过测定首发精神分裂症偏执型患者血浆及脑脊液中TNF-α的水平,探讨TNF-α在精神分裂症中发生的变化及其可能的意义。方法对30例首发偏执型精神分裂症患者和20例无精神疾患的轻微脑外伤患者(对照组),采集空腹肘静脉血,同期行腰椎穿刺取脑脊液。采用酶联免疫吸附测定法对血浆及脑脊液TNF-α水平进行检测。结果精神分裂症组血浆TNF-α水平(37.77±18.79)pg/mL及脑脊液TNF-α水平(158.30±51.60)ng/mL,与对照组相比(26.20±10.43)pg/mL、(117.05±34.98)ng/mL均明显增高,差异有显著性(均P<0.05);在精神分裂症组中,血浆与脑脊液TNF-α水平呈正相关(r=0.396,P<0.05);在对照组中,血浆与脑脊液TNF-α水平无显著相关(r=0.115,P>0.05)。结论精神分裂症偏执型患者处于免疫激活状态;正常情况下,外周的TNF-α可进入中枢,但在精神分裂症患者中,中枢内的TNF-α主要来源可能仍是由中枢自身产生的;精神分裂症偏执型患者存在血脑屏障损害,血浆及脑脊液中TNF-α的水平增高可能参与了精神分裂症的发病。

[Objective] By the examination of the blood plasma and the cerebrospinal fluid levels of the tumor necrosis faetor-α in the first episode paranoid schizophrenia, to study the changes and significance of the tumor necrosis faetor-α in the schizophrenia. [Methods] The fasting blood of ulnar vein and eerebrospinal fluid were collected in 30 first episode paranoid schizophrenics and 20 patients of cerebral trauma without psychotic disease（as the control group）. The levels of the tumor necrosis factor -α in their blood plasma and eerebrospinal fluid were assayed with emzyme-linked immunosorbent assay （ELISA）. [Results] The levels of the tumor necrosis factor -α in their blood plasma and eerebrospinal fluid [（37.77±18.79） pg/mL, （158.30±51.60） ng/mL] in the schizophrenia group were significantly higher than that in the control group[（26.20±10.43） pg/mL, （117.05±34.98） ng/mL] （P 〈0.05）. In the schizophrenia group, there were positive correlations between the levels of the tumor necrosis faetor-α in their blood plasma and eerebrospinal fluid （r=0.396, P 〈0.05）. In controls, there were no correlations between the levels of the tumor necrosis factor -α in their blood plasma and cerebrospinal fluid （r=0.115, P 〉0.05）. [Conclusions] The first episode paranoid schizophrenia might be in a state of immune activation. Although the peripheral tumor necrosis factor-αcan get into the central nervous system in normal, the main tumor necrosis factor-ctin the central nervous system is produced by itself. There exists the lesion of the blood brain barrier in the paranoid schizophrenia. The increase of tumor necrosis factor-olevel in the blood plasma and the cerebrospinal fluid maybe participate pathological lesion in the paranoid schizophrenia.