精神分裂症药物治疗后血清神经肽Y变化与治疗干预的关系

Changes of serum neuropeptide Y and therapeutic intervention in patients with schizophrenia after drug therapy

目的探讨血清神经肽Y(neuropeptide Y,NPY)水平与精神分裂症发生及其治疗干预的关系。方法采用可重复的成套神经心理状态测量(repeatable battery for the assessment of neuropsychological status,RBANS),阳性和阴性症状量表(positive and negative syndrome scale,PANSS)对125例4周未服药的精神分裂症患者(病例组)和136名健康对照(对照组)进行评估,同时采血检测血清NPY浓度。病例组单用奥氮平治疗4周后再次进行PANSS评估及血清NPY浓度检测。结果在基线期,病例组血清NPY浓度低于对照组(t=-5.79,P<0.01),病例组RBANS总分及其各因子分均低于对照组(均P<0.01),病例组血清NPY浓度与RBANS量表注意因子分呈正相关(r=0.20,P=0.04);病例组治疗4周后,血清NPY浓度较基线期升高(t=-2.23,P=0.03),PANSS总分及其分量表分均下降(均P<0.01)。治疗前后的血清NPY浓度变化与PANSS总分及其分量表分变化间的相关性无统计学意义(均P>0.05)。结论精神分裂症患者存在血清NPY水平下降,奥氮平治疗能改善血清NPY水平的下降,这可能与奥氮平的作用机制有关。然而并未发现血清NPY变化与患者的临床症状改善相关。

Objective To explore the relationship between the serum neuropeptide Y（NPY） levels and the pathogenesis, therapeutic intervention of schizophrenia. Methods One hundard twenty-five patients with schizophrenia（case group） with no medication for at least 4-week and 136 healthy controls（control group） were evaluated by Repeatable Battery for the Assessment of Neuropsychological Status（RBANS） and Positive and Negative Syndrome Scala（PANSS）. Simultaneously blood tests were performed to detect serum NPY levels. In the case group, PANSS was evaluated and blood collected again after 4 weeks of treatment with olanzapine. Result At the baseline, the serum NPY concentration was significantly lower in the case group than in control group（t=-5.79, P〈0.01）. The scores of RBANS and its factors were significantly lower in the case group than in control group（all P 0.01）. The concentration waspositively correlated with the score of the attention factor for RBANS scale（r =0.20, P =0.04）. After treatment with olanzapine for 4 weeks, the serum NPY level in the case group was significantly increased（t=-2.23, P=0.03）. The scores of PANSS total scale and subscale were significantly decreased（all P〈0.01）. There was no significant correlation between alterations of the serum level of NPY and PANSS total or subscale scores from baseline to 4-week（all P 0.05）.Conclusion The present study has revealed a significant decrease in serum NPY levels in patients with schizophrenia which can be attenuated by treatment of Olanzapine. The action of Olanzapine may be related to the mechanism of action of Olanzapine. However, there is no correlation between alterations of the serum level of NPY and the improvement in the patient＇s clinical symptoms.