精神分裂症患者脑源性神经营养因子水平及其与临床症状的关系

Decreased plasma level of brain-derived neurotrophic factor in medication-free patients with schizophrenia

目的探讨脑源性神经营养因子(BDNF)在精神分裂症病理生理机制中的可能作用。方法采用横断面病例-对照研究设计。患者组为48例精神分裂症患者,其中发病后从未治疗组31例,停止治疗组17例。正常对照组(以下简称对照组)为与患者组性别、年龄匹配的41名健康人。对患者组用阳性和阴性症状量表(PANSS)评定病情严重程度。血浆 BDNF 浓度用酶联免疫吸附试验测定。用多变量方差分析比较组间差异。结果从未治疗组[(4.5±2.2)μg/L]和停药组患者[(3.9±1.4)μg/L]血浆 BDNF 浓度均低于对照组[(6.5±2.2)μg/L](F 检验,P<0.01);而从未治疗组与停止治疗组的差异无统计学意义(P>0.05)。患者组的血浆 BDNF 浓度与 PANSS 阴性症状因子分(r=-0.509;P<0.01)及总病期呈负相关(r=-0.426;P<0.01),与发病年龄、PANSS 阳性因子分、总分的相关性均无统计学差异。结论精神分裂症患者 BDNF 浓度低于正常;BDNF 可能是参与精神分裂症病理生理机制的一种重要物质。

Objective To explore the possible role of brain-derived neurotrophic factor （BDNF） in schizophrenia. Methods Forty-eight patients with schizophrenia, who were medication-naive （MN, 31 cases） or medication-free for at least three weeks （MF, 17 cases）, and 41 sex-, age-, and education- matched healthy normal controls （NC） were consecutively involved in the study. The Positive and Negative Symptoms Scale （PANSS） was used to evaluate the severity of symptoms. The plasma level of BDNF was detected with sandwich ELISA. The mean differences of plasma concentrations of BDNF between patients and controls were compared with multivariate analyses of variance followed by post-hoc t-tests. Pearson correlation coefficients were used to measure the correlations between plasma BDNF and related illness variables. Results There were significant differences in the plasma levels of BDNF between the patients and normal controls （ F test, P 〈 0. 05 ）, and post hoc analysis showed the levels in both the MN and MF patients were lower than that in controls （ both P 〈 0. 05 ）, with no difference between the two groups of patients （P 〉0. 05）. In patients, there were no significantly differences in the BDNF levels between paranoid subtypes of diagnoses and other subtypes. There were significant inverse correlations between the BDNF levels and the duration of illness （r = -0. 426, P 〈 0. 05 ） , and score of PANSS negative symptoms （r = - 0. 506, P 〈 0. 05 ）. Conclusions Our results suggest that the brain-derived neurotrophic factor may play a role in the processing neurodevelopmental disorder of schizophrenia, which deserves further study in future.