Ⅰ型、Ⅱ型精神分裂症患者脑源性神经营养因子水平临床分析

Clinical analysis of serum levels of brain derived neurotrophic factor in type Ⅰ,Ⅱ schizophrenia patients

目的分析Ⅰ型、Ⅱ型精神分裂症患者间血清脑源性神经营养因子(BDNF)水平与阳性和阴性精神症状可能的关系,为临床诊治提供一定依据。方法抽取初诊的住院或门诊符合ICD-10精神分裂症诊断标准患者共计103例,其中Ⅰ型组63例,Ⅱ型组40例,健康对照组40例。入组后使用阳性和阴性症状量表(PANSS)判别精神症状程度,抽取晨血,测定血清BDNF浓度。结果精神分裂症患者血清BDNF水平为(21.38±4.57)μg/L,低于健康对照组的(23.68±6.14)μg/L,差异有统计学意义(P<0.05);Ⅰ型组BDNF水平为(22.50±4.41)μg/L,明显高于Ⅱ型组的(19.61±4.31)μg/L,差异有统计学意义(P<0.01),Ⅱ型组BDNF水平明显低于健康对照组,差异有统计学意义(P<0.05)。病程越长、复发次数越多,血清BDNF水平越低(P<0.05)。结论 BDNF可能参与了精神分裂症的发生、发展过程,Ⅱ型患者精神神经生化学病因基础可能不同,可作为判断预后的临床观测指标。

Objective To analyze the probable relationship between the serum brain derived neurotrophic fac‐tor （BDNF） levels and the positive and negative psychotic symptoms in the type Ⅰ and type Ⅱ schizophrenia pa‐tients in order to provide a certain basis for clinical diagnosis and treatment .Methods 103 newly diagnosed outpa‐tients or inpatients according with the ICD‐10 diagnostic criteria for schizophrenia were extracted ,including 63 cases in the type Ⅰ group and 40 cases in the type Ⅱ group .Other 40 healthy individuals were selected as the healthy con‐trol group .After joining the group ,the positive and negative symptoms scale （PANSS） was used to identify the de‐gree of mental symptoms and the morning blood was collected for detecting serum concentration of BDNF .Results Serum BDNF level in the schizophrenia patients was （21 .38 ± 4 .57）μg/L ,which was lower than （23 .68 ± 6 .14）μg/L in the healthy control group ,the difference had statistical significance（P〈0 .05）;the BDNF level in the type Ⅰ group was （22 .50 ± 4 .41）μg/L ,which was significantly higher than （19 .61 ± 4 .31）μg/L in the type Ⅱ group with statisti‐cal difference（P〈0 .01）;which in the type Ⅱ group was significantly lower than （23 .68 ± 6 .14）μg/L in the normal group with statistical difference（P〈0 .05）;the longer the disease duration ,the more frequent of recurrence and the lower the level of plasma BDNF（P〈0 .05） .Conclusion BDNF may participate in the occurrence and development process of schizophrenia .The mental neural biochemical etiology base of type Ⅱ schizophrenia patients may be differ‐ent ,which can be used as the clinical observation index for distinguishing the prognosis .