IL-1β、IL-6、TNF-α、IL-17和IL-23在精神分裂症患者血清中的表达及其临床应用价值

Expression levels and their roles of serum IL-1β,IL-6,TNF-α,IL-17 and IL-23 of schizophrenia patients

目的研究精神分裂症患者血清白细胞介素(IL)-1β、IL-6、肿瘤坏死因子α(TNF-α)、IL-17和IL-23水平变化及其在精神分裂症中的辅助诊断价值。方法选取85例精神分裂症患者(病例组),以85名体检健康者作为正常对照组。采用酶联免疫吸附试验(ELISA)检测2个组的血清IL-1β、IL-6、TNF-α、IL-17和IL-23水平,比较病例组药物治疗前、治疗3个月末的变化。采用受试者工作特征(ROC)曲线评价血清细胞因子对精神分裂症的辅助诊断价值。采用Pearson相关分析评价细胞因子水平与阳性和阴性症状量表(PANSS)评分之间的相关性。结果病例组治疗前血清IL-1β、IL-6、TNF-α、IL-17、IL-23水平高于正常对照组(P<0.01)。病例组治疗3个月末的血清IL-1β、IL-6、TNF-α、IL-17和IL-23水平均低于治疗前(P<0.01),与正常对照组比较差异无统计学意义(P>0.05)。ROC曲线分析显示,IL-1β、IL-6、TNF-α、IL-17、IL-23辅助诊断精神分裂症的曲线下面积(AUC)分别为0.723、0.772、0.686、0.685、0.679。IL-1β、IL-17、IL-23与PANSS总分、阳性症状评分、一般精神病理学症状评分、攻击危险性评分均呈正相关(P<0.05),TNF-α与阳性症状评分呈正相关(P<0.05),而IL-6与PANSS总分、阴性症状评分呈正相关(P<0.05)。结论精神分裂症患者存在IL-1β、IL-6、TNF-α、IL-17和IL-23的激活。血清细胞因子在精神分裂症的辅助诊断中有一定的价值,且与临床症状具有相关性。

Objective To investigate the changes of serum interleukin（IL）-1β,IL-6,tumor necrosis factor-alpha（TNF-α）,IL-17 and IL-23 levels in schizophrenia patients,and to evaluate the roles in the auxiliary diagnosis of schizophrenia.Methods A total of 85 patients with schizophrenia were enrolled as case group,and 85 healthy subjects were enrolled as control group. IL-1β,IL-6,TNF-α,IL-17 and IL-23 were determined by enzyme-linked immunosorbent assay（ELISA）. The changes of case group before and after treatment for 3 months were evaluated. The auxiliary diagnosis role of serum cytokines was evaluated by receiver operating characteristic（ROC） curve. Pearson correlation analysis was used to analyze the correlation between the levels of serum cytokines and the positive and negative syndrome scale（PANSS） score.Results Before treatment,serum levels of IL-1β,IL-6,TNF-α,IL-17 and IL-23 in case group were higher than those in control group（P〈0.01）. After treatment for 3 months,serum levels of IL-1β,IL-6,TNF-α,IL-17 and IL-23 in case group were lower than those before treatment（P〈0.01）,and there was no statistical significance compared with control group（P〉0.05）. The areas under ROC curves（AUC） of serum IL-1β,IL-6,TNF-α,IL-17 and IL-23 were 0.723,0.772,0.686,0.685 and 0.679. Serum IL-1β,IL-17 and IL-23 were positively correlated with PANSS total score,positive symptom score,general psychopathology score and supplemental aggression risk subscale score TNF-α was positively correlated with positive symptom score（P〈0.05）,and IL-6 was positively correlated with PANSS total score and negative symptom score（P〈0.05）.Conclusions The activation of serum cytokines（IL-1β,IL-6,TNF-α,IL-17 and IL-23） exists in schizophrenia patients,serum cytokines play roles in the auxiliary diagnosis of schizophrenia,and these levels are correlated with clinical symptoms.