脑源性神经生长因子对首发精神分裂症患者早期改善的预测作用

Serum levels of brain derived neirotrophic factor in predicting early improvement of patients with first- episode schizophrenia

目的探讨血清脑源性神经生长因子(BDNF)对首发精神分裂症患者早期改善的预测作用。方法选择90例女性首发精神分裂症患者为研究对象,给予利培酮治疗8周。在治疗前,治疗第2、8周末检测血清BDNF水平;采用阳性与阴性症状量表(PANSS)评定疗效,根据2周末PANSS减分率分为早期改善组51例(≥20%)和非早期改善组39例(<20%)。选择同期45例女性健康者为正常对照组,检测其血清BDNF水平,与精神分裂症患者进行比较分析。结果与正常对照组比较,早期改善组治疗前、治疗第2周末血清BDNF水平均明显较低(均P<0.01),治疗第8周末差异无统计学意义(P>0.05);与非早期改善组比较,治疗前,治疗第2、8周末血清BDNF水平均明显较高(均P<0.05)。非早期改善组治疗前,治疗第2、8周末血清BDNF水平均明显低于正常对照组(均P<0.01)。与自身治疗前比较,早期改善组和非早期改善组第2、8周末血清BDNF水平均明显升高(均P<0.05)。经logistic回归分析,治疗前血清BDNF水平是治疗2周末早期改善的影响因素。治疗第8周末早期改善组治疗有效率为80.4%,明显高于非早期改善组的59.0%(P<0.05)。结论首发精神分裂症患者存在BDNF异常降低,但经抗精神病药物治疗后明显改善,且治疗前BDNF水平对早期改善具有一定的预测作用。

Objective To investigate the predictive value of serum brain derived nerve growth factor （BDNF） for early improvement of patients with first-episode schizophrenia. Methods Ninety female patients with first-episode schizophrenia receiving risperidone treatment for 8 weeks （study group） and 45 healthy females （control group） were enrolled in the study. Serum BDNF levels were measured before and 2, 8 weeks after treatment. The positive and negative symptoms scale （PANSS） was evaluated before and after treatment to assess the efficacy. According to results at 2 weeks after treatment, the PANSS scores were reduced ≥20% in 51 cases （early improvement group） and reduced 〈20% in 39 cases （non-early improvement group. Results Compared with control group, serum BDNF levels in early improvement group were significantly lower than those before treatment and 2 weeks after treatment （both P〈0.01）, however, there was no difference at 8 weeks of treatment （P 〉0.05）. Compared with the non-early improvement group, serum BDNF levels were significantly higher in early improvement group before and 2, 8 weeks after treatment （P〈0.05）. Serum BDNF levels of non-early improvement group before and 2, 8 weeks after treatment were significantly lower than those in normal control group （both P〈0.01）. Compared with those before treatment, serum BDNF levels in early improvement group and non-early improvement group at 2, 8 weeks after treatment were significantly increased （both P〈O.05）. Logistic regression analysis showed that serum BDNF level before treatment was the influencing factor for the early improvement. The effective rate of the early improvement group in 8 weeks of treatment was significantly higher than that of the non-early improvement group （80.4% vs 59.0%, P〈0.05）. Conclusion The level of BDNF before treatment can be used as a predictive marker for the early improvement in patients with first-episode schizophrenia.