左甲状腺素钠辅助利培酮对首发精神分裂症患者的疗效及对血清神经功能相关因子水平的影响

Effect of sodium levothyroxine-assisted risperidone on first-episode schizophrenic patients and levels of serum neural function-related factors

目的:探讨左甲状腺素钠辅助利培酮对首发精神分裂症患者疗效以及血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)、星型胶质源性蛋白(S100B)、髓鞘碱性蛋白(MBP)、胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)水平的影响。方法:应用随机数字法将140例首发精神分裂症患者分为研究组和对照组;两组在利培酮治疗的基础上,分别服用左甲状腺素钠胶囊(25μg/d)及与之外观一致的安慰剂;疗程均为6周。治疗前后测定入组者血清游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)水平及血清NGF、BDNF、S100B、MBP、GFAP、NSE水平;并进行阳性和阴性症状量表(PANSS)及不良反应量表(TESS)评估。结果:治疗前两组各项血清学检查结果及PANSS评分比较差异无统计学意义;治疗后研究组FT3、NGF、BDNF显著高于治疗前及对照组,S100B、GFAP水平显著低于治疗前及对照组(P<0.05或P<0.01);对照组血清FT4、S100B、GFAP水平显著低于治疗前(P均<0.05)。治疗后两组PANSS评分明显降低,且研究组总分及阴性症状分明显低于对照组(P<0.05或P<0.01);两组不良反应发生率比较差异无统计学意义。结论:左甲状腺素钠辅助利培酮治疗首发精神分裂症患者的疗效比单用利培酮好;可能与提高血清NGF及BDNF水平、降低血清S100B、GFAP水平有关。

Objective:To investigate the effect of sodium levothyroxine-assisted risperidone on first-episode schizophrenic patients and levels of serum nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),astrogenic glial protein(S100 b),myelin basic protein(MBP),glial fibrillary acidic protein(GFAP),neuron specific enolase(NSE).Method:According to the method of random number table,140 first-episode schizophrenic patients were divided into study group and control group.On the basis of risperidone treatment,sodium levothyroxine capsule(25μg/d)and a placebo were administered separately for 6 weeks.Before and after treatment,the levels of serum free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)and NGF,BDNF,S100 B,MBP,GFAP,NSE of them were detected;and the patients were assessed by positive and negative syndrome scale(PANSS)and treatment emergency symptom scale(TESS).Results:Before treatment,there were no significant differences in the levels of serum FT3,FT4,TSH,NGF,BDNF,S100 B,MBP,GFAP,NSE between the two groups.After treatment,the levels of serum FT3,NGF,BDNF in the study group were significantly higher than before,while the levels of serum S100 B,GFAP were significantly lower than before(P<0.05 or P<0.01).After treatment,PANSS scores in both groups were decreased significantly,and total score and negative symptom score of PANSS in the study group were significantly lower than those in the control group(P<0.05 or P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Sodium levothyroxine-assisted risperidone has better curative effect on first-episode schizophrenic patients than risperidone alone.It may be related to the increased levels of serum NGF and BDNF and decreased levels of serum S100 B,GFAP.