阿立哌唑对精神分裂症患者临床症状及血清神经营养因子水平的影响

Effects of aripiprazole on clinical symptoms and serum neurotrophic factor levels in patients with schizophrenia

目的探讨阿立哌唑对精神分裂症患者临床症状及神经营养因子水平的影响。方法纳入40例精神分裂症患者和40名正常对照者。患者采用单一阿立哌唑治疗12周,以阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评定治疗前后临床症状,采用Stroop测验(Stroop color-word test,SCWT)、持续操作测验、数字符号编码测验及连线测验A评定患者和对照认知功能,采用酶联免疫吸附技术检测血清神经生长因子(nerve growth factor,NGF)、脑源性神经营养因子(brain derived neurotrophic factor,BDNF)及神经营养因子3(neurotrophin 3,NT-3)水平。结果治疗前后患者临床症状、认知功能及血清神经营养因子水平有统计学差异(P<0.01),且治疗前后均低于对照组(P<0.05)。治疗前患者BDNF与PANSS阴性症状分负相关(r=-0.362,P=0.022);NGF与PANSS总分(r=0.332,P=0.037)、阳性症状分(r=0.401,P=0.010)相关;NT-3与阴性症状分(r=-0.376,P=0.017)和SCWT-色词(r=0.332,P=0.037)相关。治疗后,患者BDNF升幅与PANSS总分(r=0.371,P=0.018)、阴性症状分(r=0.345,P=0.029)及一般病理分(r=0.342,P=0.031)减少值相关;NGF升幅与PANSS总分(r=0.437,P=0.005)、阳性症状分(r=0.357,P=0.024)的下降值相关。结论阿立哌唑治疗可改善精神分裂症患者的临床症状和认知功能损害,其机制可能与上调血清BDNF、NGF、NT-3水平有关。

Objective To explore the effects of aripiprazole on clinical symptoms and neurotrophic factor levels in patients with schizophrenia. Methods Forty patients with schizophrenia and 40 normal controls were included in the study. The clinical symptoms of patients receiving aripiprazole only for 12 weeks were evaluated by using the Positive and Negative Syndrome Scale（PANSS）. Stroop Color-Word Test（SCWT）, Continuous Performance Test, Digit-Symbol Coding Test and Trail Making Test-A were used to evaluate the cognitive function both in patients and controls. Serum levels of Nerve Growth Factor（NGF）, Brain Derived Neurotrophic Factor（BDNF） and Neurotrophin 3（NT-3） were measured using enzyme linked immunosorbent assay. Results The clinical scores, cognitive function and levels of neurotrophic factors were different before and after treatment（P〈0.01）. And those were significantly lower in patients than in control group（P〈0.05）. Before treatment, BDNF was negatively correlated with PANSS negative symptom score（r=-0.362, P=0.022）; NGF was related to the total score of PANSS（r=0.332, P=0.037） and positive symptoms（r=0.401, P=0.010）; NT-3 was associated with negative symptom scores（r=-0.376, P=0.017） and SCWT-color words（r=0.332, P=0.037） in patient group. After treatment, the increase in BDNF was correlated with the reduction in PANSS total score（r=0.371, P=0.018）, negative symptom score（r=0.345, P=0.029） and general pathology score（r=0.342, P=0.031）. There was a correlation of the increase of NGF with the decrease of PANSS total scores（r =0.437, P =0.005） and with positive symptom scores（r =0.357, P =0.024）. Conclusion Treatment with Aripiprazole can improve the clinical symptoms and cognitive functiona impairments in patients with schizophrenia, which may be related to the increase in serum levels of BDNF, NGF and NT-3.