童年时期虐待对精神分裂症患者血清瘦素的影响

Effect of Childhood Abuse on Serum Leptin in Patients with Schizophrenia

【目的】探讨童年虐待对精神分裂症患者血清瘦素（LP）水平的影响。【方法】选择2016年1月至2017年6月本院收治的112例首次发病的精神分裂症患者为研究对象,应用童年创伤问卷（CTQ）评估童年受虐程度和种类,根据CTQ评分结果分为受虐组（n=40）和非受虐组（n=72）。采用阳性与阴性症状量表（PANSS）评估患者的精神症状;采用ELISA法检测血清LP、5-羟色胺（5-HT）和脑源性神经营养因子（BDNF）水平。【结果】受虐组和非受虐组男女比例、首发年龄方面比较,差异具有统计学意义（P〈0.05）,而两组受教育年限比较,差异无统计学意义（P〉0.05）。受虐组CTQ总分及情感虐待、情感忽视、性虐待、躯体虐待和躯体忽视得分均显著高于非受虐组,差异具有统计学意义（P〈0.05）。受虐组PANSS总分及一般病理、阳性症状、阴性症状得分均显著高于非受虐组,差异具有统计学意义（P〈0.05）。受虐组血清LP、5-HT水平显著低于非受虐组,差异具有统计学意义（P〈0.05）;两组血清BDNF水平比较,差异无统计学意义（P〉0.05）。Spearman相关分析显示,CTQ评分与PANSS评分呈显著正相关（r=0.536,P=0.032〈0.05）,CTQ总分与LP呈显著负相关（r=-0.511,P=0.039〈0.05）。【结论】存在童年虐待的精神分裂症患者女性多于男性,且精神分裂症首发年龄更早,临床症状更严重,而受虐患者血清LP、5-HT水平与非受虐患者存在差异,在一定程度上影响精神分裂症的发生。

【Objective】To investigate the effect of childhood abuse on serum leptin in schizophrenic patients.【Methods】A total of 112 patients with schizophrenia were enrolled in our hospital from January 2016 to June 2017. The Childhood Trauma Questionnaire （CTQ） was used to assess the extent and type of child abuse. According to CTQ scores, 112 patients were divided into abused group （n=40） and non-abused group （n=72）. The psychiatric symptoms were assessed using the Positive and Negative Symptom Scale （PANSS）. Serum levels of leptin, serotonin （5-HT） and brain-derived neurotrophic factor （BDNF） were measured by ELISA.【Results】There were statistically significant differences in the starting age of abuse, and the proportion of male and female victims between the abused and non-abused groups （P〈0.05）, but there was no significant difference in the number of years of education （P〉0.05）. The total score of CTQ and scores of emotional abuse, affective neglect, sexual abuse, physical abuse and physical neglect were significantly higher in the abused group than those of non-abused group （P〈0.05）. The total score of PANSS and scores of general pathology, positive symptoms and negative symptoms were significantly higher in the abused group than those of non-abused group （P〈0.05）. The levels of serum LP and 5-HT in the abused group were significantly lower than those in the non-abused group （P〈0.05）. There was no significant difference in serum BDNF levels between the two groups （P〉0.05）. Spearman correlation analysis showed that there was a significant positive correlation between CTQ score and PANSS score （r=0.536, P=0.032〈0.05）. There was a significant negative correlation between CTQ total score and LP （r=-0.511, P=0.039〈0.05）.【Conclusion】There are more female schizophrenia than male schizophrenia cases caused by childhood abuse. The earlier age of receiving abuse, the more severe clinical symptoms exist. The difference of serum LP and 5-HT levels between the abuse and non-abuse groups reflects the occurrence of schizophrenia.