弓形虫抗体阳性与阴性的精神分裂症患者临床症状比较及相关分析

Comparison of Clinical Symptoms Between Antitoxoplasma-Seropositive and Seronegative Patients with Schizophrenia

目的:比较分析弓形虫IgG抗体阳性和阴性的精神分裂症患者的临床表现,以了解弓形虫感染对精神分裂症患者精神症状的影响。方法:以酶联免疫吸附法检测600例精神分裂症患者血清弓形虫IgG抗体水平,比较抗体阳性组和阴性组患者阳性与阴性症状量表(PANSS)评定结果。结果:弓形虫抗体阳性的精神分裂症患者阳性分量表分和兴奋、夸大、敌对性、刻板思维、紧张、装相和作态、不寻常的思维内容、注意障碍、意志障碍、冲动控制缺乏等条目上的得分高于抗体阴性组患者;而前者阴性分量表分和情绪退缩、被动/淡漠社交退缩、交谈缺乏自发性和流畅性、先占观念、主动回避社交等条目上的得分低于后者;Logistic回归分析,兴奋、敌对性、刻板思维、不寻常思维内容、注意障碍等5个条目与弓形虫IgG抗体阳性有关。结论:弓形虫抗体阳性的精神分裂症倾向于兴奋紊乱、荒谬及认知症状。弓形虫感染与精神分裂症之间的病因学联系有待进一步研究证实。

Objeetive： To investigate the relationship between toxoplasma infection and schizophrenia by comparing and analyzing the clinical symptoms between the antitoxoplasma-seropositive and seronegative patients with schizophrenia. Methods： Six hundred cases of first-episode schizophrenia were examined the serum reactivity to IgG antitoxoplasma antibody by Enzyme Linked Immunosorbent Assay （ELISA）. And the clinical symptoms of the patients were scored by use of the Positive and Negative Syndrome Scale （PANSS）. Results： Compared to IgG-seronegative schizophrenia, IgG-seropositive schizophrenia group was higher in the positive subscale score（the score of the following items including excitement, grandiosity, hostility, stereotyped thinking, tension, mannerism and posturing, unusual thought content, poor attention, disturbance of volition and poor impulse control） ; and was lower in the negative subscale score and the score of emotional withdrawal, passive/apathetic social withdrawal, lack of spontaneity and flow of conversation, preoccupation and active social avoidance. Logistic regression analysis revealed that the items of excitement, hostility, stereotyped thinking, unusual thought content and poor attention were correlated with IgG seropositivity. Conclusion： Toxoplasma infection may be related with some of the symptoms of schizophrenia. Further prospective study is necessary to verify the findings.