以阳性、阴性症状为主的首发精神分裂症患者血清蛋白因子水平与PANSS评分的相关性

Association of serum protein factors levels with scores of Positive and Negative Syndrome Scale in first- episode schizophrenia patients characterized by positive or negative symptoms

目的探讨以阳性、阴性症状为主的首发精神分裂症患者血清白细胞介素-6(IL-6)、钙结合蛋白S100β(S100β)、神经营养因子-3(NT-3)三种蛋白因子的浓度水平差异以及与其阳性与阴性症状量表(PANSS)评分中阳性症状、阴性症状、认知、兴奋及抑郁情绪评分之间的相关性。方法以2014年1月-2015年11月于昆明医科大学第一附属医院精神科门诊及住院的首发精神分裂症患者为患者组,选取同期来自本院体检中心的健康体检者为对照组。采用酶联免疫吸附技术(ELISA)测定44例以阳性症状为主的首发精神分裂症患者(阳性组)、38例以阴性症状为主的首发精神分裂患者(阴性组)和78名健康对照者(对照组)血清中蛋白因子IL-6、S100β、NT-3的浓度,通过PANSS对患者组和对照组的阳性症状、阴性症状、认知功能、兴奋症状及抑郁情绪进行定量评估。结果 1三组血清IL-6浓度比较,差异有统计学意义(F=31.34,P<0.01),两两比较,对照组IL-6浓度低于阳性组和阴性组,阳性组低于阴性组,差异均有统计学意义(P均<0.05);2三组S100β浓度比较,差异有统计学意义(F=9.19,P<0.05),两两比较,阳性组、阴性组的S100β浓度均高于对照组(P均<0.05),两患者组间比较差异无统计学意义(P>0.05);3三组NT-3浓度比较,差异有统计学意义(F=10.45,P<0.05),两两比较,阳性组、阴性组NT-3浓度均低于对照组(P均<0.05),两患者组间比较差异无统计学意义(P>0.05)。阳性组血清NT-3浓度与兴奋评分呈正相关(r=0.38,P<0.05)。结论以阴性症状为主的首发精神分裂症患者的神经炎症反应较以阳性症状为主的患者更强烈,以阳性症状为主的首发精神分裂症患者的异常兴奋可能与其细胞营养不足有关,以阳性症状为主的首发精神分裂症的病理机制可能与以阴性症状为主的首发精神分裂症不尽相同。

Objective To explore serum levels of interleukin 6( IL- 6),S100 calcium- binding proteinβ( S100β),neurotrophin- 3( NT- 3) in first- episode schizophrenia patients characterized by positive or negative symptoms and the association of IL- 6,S100 βand NT- 3 serum levels with scores of positivesymptom,negativesymptom,cognitive function,excited symptom and depressive emotion from Positive and Negative Syndrome Scale( PANSS) in these patients. Methods Cases( first- episode schizophrenia patients) were collected from outpatient and inpatient departments of the First Affiliated Hospital of Kunming Medical University from January 2014 to November 2015. Controls were collected from Health Examination Centre of the same hospital during the same period. 44 first- episode schizophrenia patients characterized by positive symptoms( positive group),38 first- episode schizophrenia patients characterized by negative symptoms( negative group) and 78 healthy controls( control group) were collected.The serum levels of IL- 6,S100β and NT- 3 were measured by enzyme- linked immunosorbent assay( ELISA). Positive symptom,negative symptom,cognitive function,excited symptom and depressive emotion scores were measured by Positive and Negative Syndrome Scale( PANSS) in patients and controls. Results 1 The difference of IL- 6 serum level among the three groups was statistically significant( F = 31. 34,P < 0. 01),IL- 6 serum level in control group was lower than those of positive or negative groups and the differences were statistically significant( P < 0. 05). IL- 6 serum level in the positive group was lower than that of the negative group and the difference was statistically significant( P < 0. 05). 2The difference of S100β serum level among the three groups wasstatistically significant( F = 9. 19,P < 0. 05),S100β serum level in control group was lower than those of positive or negative groups and the differences were significant( P < 0. 05). The difference of S100β serum level between the positive and negative groups was not statistically significant( P > 0. 05). 3The difference of NT- 3 serum level among the three groups was statistically significant( F = 10. 45,P < 0. 05),NT- 3 serum level in the control group was higher than those of positive or negative groups and the differences were significant( P < 0. 05). However,the difference of NT- 3 serum level between the positive and negative groups was not statistically significant( P > 0. 05). In positive group,NT- 3 serum level was associated with the score of excited symptom( r = 0. 38,P < 0. 05).Conclusion First- episode schizophrenia patients characterized by negative symptoms have more severe neuroinflammatory responses than those characterized by positive symptoms. The excitement in first- episode schizophrenia patients characterized by positive symptoms may be associated with malnutrition in neuro cells. The pathophysiology between the first- episode schizophrenia patients characterized by positive symptoms and those characterized by negative symptoms may be different.