血浆氧化应激标志物水平与慢性精神分裂症患者认知障碍的关系

The relationship between the level of plasma oxidative stress markers and cognitive impairment in patients with chronic schizophrenia

目的探讨血浆同型半胱氨酸(Hcy)、胆红素、白蛋白、尿酸等氧化应激标志物水平与慢性精神分裂症患者认知障碍之间的关系。方法测定208例慢性精神分裂症患者血浆Hcy、胆红素、白蛋白及尿酸水平。通过蒙特利尔认知评估量表(MoCA)的评估结果,将慢性精神分裂症患者分为认知障碍组和非认知障碍组,对结果进行统计分析。结果认知障碍组血浆Hcy水平高于非认知障碍组,白蛋白水平低于非认知障碍组,差异有统计学意义(Z=-3.279,P<0.01;t=2.265,P<0.05)。两组间胆红素、尿酸水平差异无统计学意义(Z=-0.346、Z=-1.800,均P>0.05)。对于精神分裂症患者的认知功能,血浆Hcy是危险性因素(OR=1.097,95%CI为1.015~1.185,P<0.05),血浆白蛋白是保护性因素(OR=0.844,95%CI为0.745~0.956,P<0.01)。结论氧化应激可能参与精神分裂症认知障碍的发病过程,血浆Hcy、白蛋白水平可作为潜在的临床评价指标。

Objective To explore the relationship between the level of plasma oxidative stress markers such as homocysteine(Hcy),bilirubin,albumin,uric acid,etc.and cognitive impairment in patients with chronic schizophrenia.Methods Plasma Hcy,bilirubin,albumin and uric acid levels were measured in 208 patients with chronic schizophrenia.According to the assessment results of Montreal Cognitive Assessment(MoCA),the patients with chronic schizophrenia were divided into the cognitive impairment group and the non-cognitive impairment group,and the results were statistically analyzed.Results The plasma Hcy level in the cognitive impairment group was higher than that in the non-cognitive impairment group,and the albumin level was lower than that in the non-cognitive impairment group.The difference was statistically significant(Z=-3.279,P<0.01;t=2.265,P<0.05).There was no significant difference in bilirubin and uric acid levels between the two groups(Z=-0.346,Z=-1.800,for both P>0.05).For cognitive function of patients with schizophrenia,plasma Hcy was a risk factor(OR=1.097,95%CI was 1.015-1.185,P<0.05),and plasma albumin was a protective factor(OR=0.844,95%CI was 0.745-0.956,P<0.01).Conclusion Oxidative stress may be involved in the pathogenesis of cognitive impairment in schizophrenia,and plasma Hcy and albumin levels can be taken as potential clinical evaluation indexes.