首发吸烟精神分裂症患者血清神经元特异性烯醇化酶、认知功能及临床特征研究

Serum level of neuron-specific enolase,cognitive function and clinical characteristics in first-episode smoking schizophrenics

目的研究首发吸烟精神分裂症患者的血清神经元特异性烯醇化酶(NSE)水平、认知功能及临床特征,探索吸烟与精神分裂症的关系。方法调查70例首发的男性精神分裂症患者的吸烟状况和临床资料,Fager-strom尼古丁依赖量表(FTND)评定吸烟患者尼古丁依赖程度,词汇流畅、视觉再生、数字广度、连线试验A和B、威斯康星卡片分类测验(WCST)5项神经心理测验评测认知功能,化学发光法检测血清NSE水平。结果①首发男性精神分裂症患者吸烟率为57.14%(40/70),75%(30/40)吸烟患者在起病前已吸烟,吸烟患者的发病年龄(24.87±6.45)岁低于非吸烟患者(30.86±7.39)岁(t=3.54,P<0.01);②吸烟与非吸烟患者各认知功能比较无差异;③吸烟患者的血清NSE水平(17.57±8.70)ng/ml高于非吸烟患者(12.68±4.21)ng/ml(t=2.83,P<0.01),并与FTND分呈正相关(r=0.39,P=0.011)。结论吸烟可能是精神分裂症的环境易感因素之一。

Objective To study serum level of neuron -specific enolase, cognitive function and clinical characteris- tics in first- episode smoking schizophrenics, and to explore the relationship between smoking and schizophrenia. Methods The smoking status and clinical data in 70 male first - episode schizophrenic patients were investigated. Nic- otine dependence degree was rated by Fagerstrom Test for Nicotine Dependence（FTND）. Cognitive function were evalu- ated with 5 neuropsyehological tests including semantic fluency, visual reproduction, digit span, Trail Making test A and B, Wisconsin Card Sorting Test （WCST）. The serum level of neuron - specific enolase was measured by automated chemiluminescent enzyme immunoassays. Results （1）Smoking rate in male first - episode schizophrenics was 57.14% （40/70） and 75% （30/40） smoking patients started to smoke before the onset of their schizophrenic illness. Age at onset of illness in smoking patients （24.87 ±6.45 years） was significantly younger than that in non - smoking patients （ 30.86 ± 7.39 years） （ t = 3.54 ,P 〈0.01 ）. （2） The performance of cognitive tests showed no significant differences between smoking patients and non - smoking patients. （3）The serum level of neuron - specific enolase in smoking patients （ 17.57 ±8.70ng/ml） was significantly higher than that in non - smoking patients （ 12.68 ±4.21 ng/ml） （ t = 2.83, P 〈0.01 ）. The serum level of neuron- specific enolase in smoking patients was significantly positively correlated with score of FTND（ r = 0.39, P = 0.011 ）. Conclusion Smoking may be one of environmental vulnerability factors for schizophrenia.