精神分裂症患者利培酮治疗前后细胞间黏附分子-1等指标的观察

Changes of C-reactive protein and intercellular adhesion molecule-1 in patients with schizophrenia before and after risperidone treatment

目的探讨精神分裂症患者CRP(C-反应蛋白)、sICAM-1(细胞间黏附分子-1)和正常健康人的差别,从而了解其临床意义;了解两者对利培酮治疗的反应。方法选择首发精神分裂症患者50例,均服用利培酮治疗,2周加至治疗的剂量为6 mg/d,经过8周的治疗,治疗前后分别测定血清中CRP、sICAM-1水平,用阳性和阴性综合征量表(Positive and NegativeSyndrome Scale,PANSS)评估精神分裂症的严重程度。选取性别和年龄匹配的正常对照50人进行CRP,sICAM-1水平的测定。结果精神分裂症患者的sICAM-1水平高于正常对照组[(664.42±76.80),(52.28±6.78),P<0.01);经过8周的利培酮治疗后,sICAM-1降低(50.73±5.03),较治疗前差异有统计学意义(P=0.000);与正常对照组相比差异无统计学意义。CRP在治疗前和治疗后与对照组相比差异无统计学意义[(7.86±0.73),(7.6±0.76),(6.81±1.85),P>0.05)。相关分析显示,治疗前sICAM-1水平与G分值之间有正相关关系(r=0.402,P<0.01)。结论精神分裂症病人中sICAM-1水平明显的高于正常人群,经过利培酮8周治疗后恢复至正常人群的水平,sICAM-1与精神分裂症的阳性症状和阴性症状和总评分之间没有相关性,但是与一般精神病理症状呈正相关。CRP经利培酮治疗在精神分裂症患者中没有变化。

Objective To investigate the clinical value of C- reactive protein and intercellular adhesion molecule- 1 in schizophrenia patients through comparison with healthy people,so as to understand the correlation of the two index with risperidone.Methods Fifty cases of first- episode schizophrenia were selected to receive risperidone treatment for 8 weeks,and the levels of C- reactive protein and sICAM- 1 were detected before and after risperidone treatment. Then Positive and Negative Syndrome Scale（ PANSS） were used to evaluate the severity of schizophrenia. At the same time,another 50 healthy people with the matched gender and age were selected to detect the levels of C- lereactive protein and sICAM- 1. Results sICAM- 1 level was significantly higher in schizophrenic patients than normal controls before treatment（ P〈0.01）,and decreased distinctly after risperidone treatment,showing no statistical difference with the control group. While CRP level had no obvious change before and after risperidone treatment,and both showed no statistical difference with the control group（ P〉0.05）. There was positive correlation between the expression level of sICAM- 1 and G scores of PANSS before treatment（ r = 0. 402,P〈0.01）. Conclusion sICAM- 1 had no correlation with positive symptoms,negative symptom and the total scores of PANSS in schizophrenia patients,but positively correlated with general phychopathological symptoms. Risperidone treatment has no influence on CRP level in schizophrenia patients.