女性精神分裂症患者雌激素水平及其与精神症状及糖脂代谢的关系

Estrogen levels and its relationship with psychotic symptoms and glucolipid metabolism in female patients with schizophrenia

目的:探讨女性精神分裂症患者雌激素水平及其与精神症状及糖脂代谢的关系。方法:检测107例未服药或停药超过3个月且月经周期规律的女性精神分裂症患者血清雌激素相关指标;根据雌激素水平分为低雌激素组(n=47)和正常雌激素组(n=60);以阳性和阴性症状量表(PANSS)评估患者的精神症状;检测患者糖脂代谢相关指标(空腹血糖、三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、载脂蛋白B、脂蛋白α);由空腹血糖及三酰甘油水平计算简易指数(Ty G);分析雌激素水平与精神症状及糖脂代谢的相关性。结果:低雌激素组PANSS总分、一般病理分及空腹血糖水平明显高于正常雌激素组(P均<0.05);女性精神分裂症患者雌激素水平与血清高密度脂蛋白、载脂蛋白A水平呈正相关(r=0.303,P=0.002;r=0.329,P=0.001);与Ty G指数呈负相关(r=-0.227,P<0.05)。结论:低雌激素水平可能是影响女性精神分裂症患者精神症状及糖代谢异常的危险因素之一。

Objective： To investigate the estrogen level and its relationship with psychotic symptoms and glucolipid metabolism in female patients with schizophrenia. Method： The serum estrogen level was detected in 107 female patients with schizophrenia who had regular menstrual cycle and did not take medicine or stop medicine more than 3 months. According to the serum estrogen level,the patients were divided into the low estrogen group（ 47 cases） and the normal estrogen group（ 60 cases）. All of the patients were assessed by positive and negative syndrome scale（ PANSS）,and the levels of glucolipid metabolism index（ including fasting blood glucose,triglyceride,total cholesterol,high-density lipoprotein cholesterol,low density lipoprotein,apolipoprotein B and apolipoprotein B,lipoprotein α） were detected. The simple index（ Ty G） was calculated from fasting serum triglyceride and plasma glucose. Results： Compared with the normal estrogen group,the PANSS general scores,total score,the serum fasting blood glucose level in the low estrogen group were increased significantly（ all P〈0. 05）. The estrogen level in female schizophrenic patients was positively correlated with high density lipoprotein and apolipoprotein A（ r = 0. 303,P = 0. 002; r = 0. 329,P = 0. 001）,and negatively correlated with Ty G index（ r =- 0. 227,P〈0. 05）. Conclusion： It is implied that the lower serum estrogen level may be one of the risk factors of psychotic symptoms and abnormal glucose metabolism in female schizophrenic patients.