帕利哌酮治疗首发精神分裂症患者的疗效研究

Effect of Paliperidone on Patients with First-episode Schizophrenia

目的:观察帕利哌酮治疗首发精神分裂症患者的疗效及对血清白介素-1β(IL-1β)、IL-2、IL-6和脑源性神经营养因子(BDNF)的水平的影响。方法:选择首发精神分裂症患者80例为精神分裂症组,采用帕利哌酮治疗8周,治疗前后采用酶联免疫吸附法检测血清IL-1β、IL-2、IL-6和BDNF水平。同期检测60名健康志愿者(正常对照组)上述指标。采用阳性与阴性症状量表(PANSS)评估精神症状,采用个人和社会功能量表(PSP)评估社会功能。结果:精神分裂症组治疗前的PANSS总分为(94.17±16.34)分,治疗第8周末为(46.09±12.52)分,痊愈68例,显著进步10例,好转2例;治疗前PSP评分为(47.94±10.88)分,治疗8周末PSP评分为(68.23±17.65)分,与治疗前比较,社会中有益的活动及扰乱及攻击行为评分有显著性差异(P<0.01)。治疗前精神分裂症组血清中IL-1β、IL-2、IL-6水平均显著高于正常对照组(P<0.01),血清BDNF水平低于正常对照组(P<0.05);治疗后血清IL-1β、IL-2水平与治疗前相比明显下降,有显著性差异(P<0.01);BDNF水平较治疗前有明显升高,差异有统计学意义(P<0.05)。治疗前IL-2水平与PANSS阳性症状评分呈正相关(r=0.551,P<0.05);治疗后BDNF水平与PSP评分呈正相关(r=0.692,P<0.05)结论:精神分裂症患者存在免疫紊乱,处于免疫激活状态。

Objective： To investigate the effects of Paliperidone on patients with first-episode schizophrenia, and to examine the effects in levels of serum interleukin-1β （IL-1β）, IL-2, IL-6 and brain-derived neurotrophic factor （BDNF）. Methods： Eighty patients with first-episode schizophrenia were enrolled in the schizophrenic group, and were treated with Paliperidone for eight weeks. The levels of Serum IL-1 β, IL-2, IL-6 and BDNF were measured with enzyme linked immunosorbent assay （ELISA） in 60 healthy volunteers （normal control group） and the schizophrenic group. The symptoms of patients were measured with positive and negative syndrome scale （PANSS）, and the PSP scale was used to assess their social function. Results： The PANSS score of schizophrenic group was （94.17±16.34） before the treatment, and was （46.09±12.52） at the 8th week of the treatment. Sixty-eight cases were cured, 10 cases were significantly improved, and 2 cases were improved. Similarly, the PSP score of schizophrenic group was （47.94±10.88） before the treatment, and was （68.23 ±17.65） at the 8th week of the treatment. The scores of social beneficial activities and disrupt and aggression were significantly different after therapy （P〈 0.01）. Before the treatment, the serum levels of IL-1 β, IL-2 and IL-6 in the schizophrenic group were significantly higher than those in the normal control group （P〈0.01）, and the serum levels of BDNF in the schizophrenic group was lower than that in the normal control group （P〈0.05）. The serum levels of IL-1 βand IL-2 in the schizophrenic group were significantly decreased after the treatment（P〈0.01）, and the serum level of BDNF in the schizophrenic group was significantly increased after the treatment （P〈0.05）. There was a positive correlation between the IL-2 level and the PANSS positive symptom scores before the treatment （r=0.551, P〈0.05）, and a positive correlation between the BDNF level of and the PSP scores after the treatment （r=0.692,P 〈0.05）. Conclusion： Schizophrenic patients present a state of immune activation.