奎硫平对首发精神分裂症患者脑源性营养因子的影响

Effect of Quetiapine on Brain-derived Neurotrophic Factors in Patients with First-episode Schizophrenia

目的观察奎硫平对首发精神分裂症患者血清脑源性营养因子(BDNF)的影响,探讨BDNF和精神症状、认知功能的关系。方法首发精神分裂症患者80例(治疗组),给予奎硫平初始剂量100 mg·d-1,平均剂量为(580±120)mg·d-1,po,qd,共4周。分别于治疗前后采用阳性和阴性症状量表(PANSS)、威斯康星卡片分类测验(WCST)评估精神症状和认知功能,采用酶联免疫吸附法检测血清BDNF水平。以健康体检者80例作为对照组。结果治疗组和对照组治疗前BDNF浓度分别为(13.72±8.79),(23.67±10.13)ng·mL-1(P<0.01),治疗组治疗后BDNF浓度(18.02±9.06)ng·mL-1,仍低于对照组(P<0.05)。治疗后患者PANSS量表总分及各分量表分下降,WCST分类数、正确应答数增加,错误应答数减少。血清BDNF浓度变化率和阴性症状(SANS)变化率呈正相关(r=0.54,P=0.032),和正确应答数呈正相关。结论奎硫平可提高精神分裂症患者BDNF水平,BDNF变化和阴性症状、认知功能相关。

Objective To investigate the effects of quetiapine on serum levels of brain-derived neurotrophic factors （ BDNF） and the correlation between BDNF and psychiatric symptoms and cognitive function in patients with first-episode schizophrenia. Methods Eighty patients with first-episode schizophrenia （ treatment group） were treated with quetiapine orally for 4 weeks,at initial dose of 100 mg·d^-1 and average dose of （580±120） mg·d^-1 . The psychiatric symptoms were evaluated by using the positive and negative syndrome scale （ PANSS） . The cognitive function was assessed by using Wisconsin cards sort test （ WCST） . The serum BDNF level was detected with enzyme-linked immunosorbent assay （ ELISA） . Results The serum level of BDNF was markedly lower in schizophrenic patients before[（13. 72±8. 79） ng·mL^-1,P〈0. 01] and after treatment[（18. 02±9.06） ng·mL^-1,P〈0.05]in comparison with normal controls（23. 67±10. 13） ng·mL^-1]. After treatment,the PANSS total scores and subscale scores decreased,WCST number of categories and the number of correct answers increased,and the number of wrong answers reduced. There was a positive correlation between the serum BDNF and negative symptoms （ SANS） （ r= 0. 54, P=0. 032）,and the number of correct answers. Conclusion The quetiapine significantly increases serum level of BDNF in schizophrenia patients,which correlates positively with improvements in symptoms and cognitive function.