急性期精神分裂症患者睡眠与血小板5-HT的关系

Relationship between sleep quality and concentrations of platelet 5 -- hydroxytryptamine in patients with schizophrenia

目的探讨急性期精神分裂症患者精神症状、睡眠质量与血小板5-HT浓度的关系。方法将符合入组标准的精神分裂症患者68例按入院的先后顺序分为喹硫平组34例和阿立哌哇组34例，用高效液相色谱仪（HPLC—ECD）在治疗前后测定血小板5-HT浓度，用匹兹堡睡眠质量指数（PSQI）和睡眠状况自评量表（SRSS）进行主观睡眠评价，用阳性和阴性症状量表（PANSS）、简明精神病评定量表（BPRS）评定精神症状。正常对照组30例。结果患者组治疗前5-HT浓度与对照组比较，差异无统计学意义（P〉0．05），对照组、患者组治疗前后血小板5-HT浓度性别比较差异无统计学意义（P〉0．05）。多元逐步回归分析显示，患者组治疗前5-HT浓度与PSQI总分呈正相关（r=0．328，P=0．013）；治疗后5-HT浓度与病程、家族史、首次发病年龄呈正相关（r=0．422，P=0．001；r=0．522，P=0.000；r=0．575，P=0.000）；5-HT浓度变化率与治疗前PSQI因子分--日间功能、入睡时间及家族史、治疗前SRSS总分呈正相关（r=0．429，P=0．001；r=0．644，P=0．000；r=0．539，P=0．000；r=0．694，P=0．000）。结论血小板5-HT浓度在一定程度反映了中枢5-HT的功能，以血小板5-HT含量作为精神分裂症的生物学标记还有待于进一步探讨。

Objective To investigate the relationship between psychiatric symptom, sleep quality and concentrations of platelet 5--hydroxytryptamine （5--HT） in patients with schizophrenia. Methods Sixty--eight patients with schizophrenia meeting International Classification of Diseases--10 （ICD--10） were enrolled in the study, and divided into two groups according to the sequence of admission, quetiapine group and aripiprazole grouping which 34 patients were included. The concentrations of platelet 5-- HT were measured with high performance liquid chromatography method （HPLC--ECD） at pre--treatment, and the end of 8th week after treatment. The positive and negative syndrome scale （PANSS） and brief psychiatric rating scale（BPRS） were used to evaluate the psychopathology. Pittsburg sleep quality index （PSQI） and SRSS （Self--Rating Scale of Sleep） were used to estimate subjective sleep quality. Thirty normal cases were used as control. Results There was no difference in the average platelet 5-- HT concentrations between patient group and normal control group （P 〉 0.05）. To compare in terms of gender, the 5-- HT concentrations of pre-- treatment and post-- treatment had no difference in both pa- tient and normal control groups （P 〉 0. 05）. Stepwise regression analysis showed that the platelet 5-- HT concentrations of pre-- treatment in patient group were positively correlated with total scores of PSQI （r = 0. 328, P = 0.013）. The 5--HT concentrations of post--treatment, however were positively correlated with course of disease family history and age of onset （r = 0. 422, P = 0.001 ; r = 0. 522, P = 0. 000;r = 0. 575, P = 0. 000）. The changing rate of platelet 5--HT concentrations was positively correlated with factor scores of PSQI--ability of daytime, fall asleep time, family history, total scores of SRSS at the pre--treatment （r= 0. 422,P = 0. 00l ; r= 0. 522,P= 0. 000;r= 0. 575,P= 0. 000）. Conelusions Platelet 5-- HT concentrations may partly reflect the 5-- HT function of CNS. It is not for sure that platelet 5- HT content regarded as a biological marker of schizophrenia. Further investigation would be needed.