性激素水平与首诊精神分裂症患者疾病严重程度的关系

Study on the Relationship Between Sex Hormone Levels and Severity of Initially Diagnosed Schizophrenia

目的:探讨性激素水平与首诊精神分裂症患者疾病严重程度的关系。方法:选取2014年8月-2016年7月我院精神科收治的首诊精神分裂症26例患者为观察组,观察组患者均接受经典抗精神药物治疗,治疗8周,同时选取28例同期入院正常体检者男性为对照组,分别抽取治疗前后观察组患者及对照组受检者轴窝静脉血,检测两组受检者血清中促滤泡成熟激素(FSH)、黄体酮生成素(LH)、催乳素(PRL)、雌二醇(E2)、孕酮(P)、睾酮(T)含量,并比较两组阳性与阴性症状量表(PANSS)评分及性激素与PANSS量表的相关性。结果:治疗前观察组患者在FSH、LH、PRL水平均显著高于对照组(t=2.254,4.708,8.020;P<0.05),而E2、P水平均显著低于对照组(t=5.845,4.750;P<0.05);治疗后患者FSH、E2、P水平较治疗前显著升高(t=2.025,3.751,4.111;P<0.05),而在LH、PRL水平较治疗前显著降低(t=2.094,4.459;P<0.05)。观察组患者PANSS总分及各量表评分均显著低于治疗前(t=6.287,6.927,3.133,3.360;P<0.05),阴性症状评分和PANSS总分与血清中PRL水平均呈正相关(r=0.367,0.338;P<0.05),而与E2呈负相关(r=-0.474,-0.451;P<0.05)。结论:首诊男性精神分裂症患者与正常健康者血清激素水平存在明显差异,高泌乳素水平或低雌二醇水平可能是男性精神分裂症患者的发病机制之一。

Objective：To investigate the relationship between sex hormone levels and the severity of initially diagnosed schizophrenia.Methods：A total of 26 patients with initially diagnosed schizophrenia who were admitted to the psychiatric department of our hospital during August 2014-July 2016 were selected as the observation group,and all of them were treated with classical antipsychotic drugs for 8 weeks.Another 28 normal male patients admitted for physical examination were selected as the control group at the same time.The cubital fossa venous blood of both groups was collected to detect the levels of serum follicle stimulating hormone（FSH）,luteinizing hormone（LH）,prolactin（PRL）,estradiol（E2）,progesterone（P）and testosterone（T）.Scores of the positive and negativesymptoms scale（PANSS）were compared between the two groups and the correlation between sex hormones and PANSS score was analyzed.Results：The levels of FSH,LH and PRL in the observation group were significantly higher than those in the control group（t=2.254,4.708,8.020;P0.05）,while the levels of E2 and P were significantly lower than those in the control group（t=5.845,4.750;P0.05）.After treatment,the levels of FSH,E2 and P were significantly higher than those before treatment（t=2.025,3.751,4.111;P0.05）,while the levels of LH and PRL were significantly lower than those before treatment（t=2.094,4.459;P0.05）.The negative score of PANSS and the total score of PANSS were positively correlated with the level of PRL in serum（P0.05）,and the scores of PANSS were significantly lower than those of the control group（t=6.287,6.927,3.133,3.360;P0.05）.Negative score and PANSS score were positively correlated with PRL（r=0.367,0.38;P 0.05）,but negatively correlated with E2（r=-0.474,-0.451,P0.05）.Conclusion：There is a significant difference in serum hormone levels between patients with initially diagnosed schizophrenia and normal male people.High PRL level or low E2 level may be involved in the pathogenesis of male patients with schizophrenia.