自由基代谢与精神分裂症临床症状和药物治疗的关系

The involvement of free radicals in schizophrenia,and the relationship with clinical symptoms and antipsychotic treatment

目的 :探讨自由基代谢与精神分裂症临床症状和药物治疗的关系。 方法 :是否治疗的慢性精神分裂症患者各 40例分别评定阳性和阴性症状量表 (PANSS) ,并测定膜脂质过氧化产物丙二醛 (MDA)含量、铜 /锌超氧化物歧化酶 (Gu- Zn SOD)和谷胱苷肽过氧化物酶 (GSH- Px)活性。 结果 :与健康对照组相比 ,未治疗组患者 MDA含量和 GSH- Px活性显著增加 ,治疗组患者无显著改变 ;而两组患者 SOD活性显著降低 ;未治疗组患者 MDA含量和 SOD活性呈负相关 ;MDA及 GSH- Px活性均与某些阴性症状呈正相关。 结论 :过氧化反应与疾病本身相关 ,并可能加重阴性症状 ,提示早期抗氧化剂辅助治疗的重要性。有些抗精神病药物可能作为抗氧化剂 ,以清除自由基 。

Objective:To investigate the involvement of free radicals and the relationship of oxidative stress with clinical symptoms and antipsychotic drug treatment in schizophrenia. Method:A large cohort of medicated (n=40),unmedicated (n=40) chronic patients with schizophrenia were identified and rated on PANSS.The blood was taken for measurement of plasma malondialdehyde (MDA) levels and activities of superoxide dismutase (SOD) in erythrocytes and of glutathione peroxidase (GSH Px) in plasma. Results:Relative to normal controls,unmedicated patients showed significant elevation of both MDA and GSH Px,but patients medicated with antipsychotic drugs had similar levels to controls;both patient groups showed significant reduction in SOD.In unmedicated patients,MDA levels were reqatively correlated with SOD activity,MDA levels and GSH Px activity were correlated positively with the negative symptom cluster.Increased level of plasma MDA was significantly inversely correlated with decreased RBC SOD activity. Conclusion:Unmedicated chronic schizophrenic patients show evidence of increased oxidative stress,which may aggravate the development of negative symptoms.This has implications for the pathology and antioxidant adjunctive treatment of schizophrenia.Some antipsychotic drugs may act as antioxidants to protect against free radical mediated cellular damage in schizophrenia.