首发精神分裂症患者外周血氧化应激水平与认知功能的相关性研究

Study on the Correlation Between Peripheral Blood Oxidative Stress Level and Cognitive Function in Patients with First Episode Schizophrenia

目的研究首发精神分裂症患者外周血氧化应激及认知功能水平变化情况。方法选取2018年3月~2019年3月在我院治疗的46例首发精神分裂症患者作为观察组,并选取同期在我院体检的30例健康人群作为对照组,检测两组外周血总超氧化物歧化酶(T-SOD)活性、丙二醛(MDA)水平、一氧化氮(NO)水平、谷胱甘肽过氧化物酶(GSH-Px)活性、过氧化氢酶(CAT)活性、总抗氧化能力(T-AOC)能力、认知功能障碍评分、精神分裂症评分,观察组采用奥氮平治疗8周,比较观察组与治疗前及对照组T-SOD、MDA、NO、GSH-Px、CAT、T-AOC水平,分析外周血氧化应激指标与认知功能障碍的相关性。结果治疗前,观察组T-SOD、GSH-P、MDA低于对照组,CAT、NO高于对照组,差异有统计学意义(P<0.05);两组T-AOC比较,差异无统计学意义(P>0.05);治疗后,观察组T-AOC、T-SOD、MDA、NO、GSH-Px、CAT与治疗前比较,差异无统计学意义(P>0.05);观察组认知功能障碍评分低于对照组,差异有统计学意义(P<0.05);治疗后观察组认知功能障碍评分高于治疗前,差异有统计学意义(P<0.05);Logistic回归分析显示,外周血NO表达水平与语言能力评分呈负相关(r=-0.188),T-AOC与注意力评分呈正相关(r=0.231),与T-SOD、MDA、GSH-Px、CAT各氧化应激指标变化无相关性,差异无统计学意义(P>0.05)。结论首发精神分裂症患者存在外周血氧化应激指标表达水平和认知功能异常,奥氮平可一定程度改善患者认知障碍,但对氧化应急标记物无影响。同时外周血氧化应激标记物表达水平与患者认知功能障碍评分无相关性,NO表达水平上调和T-AOC能力升高可能是精神分裂症发病机制之一。

Objective To study the changes of peripheral blood oxidative stress and cognitive function in patients with first-episode schizophrenia.Methods A total of 46 patients with first-onset schizophrenia treated in our hospital from March 2018 to March 2019 were selected as the observation group,and 30 healthy people who received physical examinations in our hospital during the same period were selected as the control group.Oxide dismutase(T-SOD)activity,malondialdehyde(MDA)level,nitric oxide(NO)level,glutathione peroxidase(GSH-Px)activity,catalase(CAT)activity,total antioxidant capacity(T-AOC)capacity,cognitive dysfunction score,schizophrenia score,the observation group was treated with olanzapine for 8 weeks,the observation group was compared with the pre-treatment and control group T-SOD,MDA,NO,GSH-Px,CAT,T-AOC levels,and analyze the correlation between peripheral blood oxidative stress indicators and cognitive dysfunction.Results Before treatment,the observation group's T-SOD,GSH-P,and MDA were lower than those of the control group,and CAT and NO were higher than those of the control group,the difference was statistically significant(P<0.05);the two groups had no statistically significant difference in T-AOC(P>0.05);After treatment,there was no significant difference between T-AOC,T-SOD,MDA,NO,GSH-Px,CAT in the observation group and before treatment(P>0.05);cognitive dysfunction in the observation group score was lower than that of the control group,the difference was statistically significant(P<0.05);the cognitive dysfunction score of the observation group after treatment was higher than that before the treatment,the difference was statistically significant(P<0.05);Logistic regression analysis showed that peripheral blood NO expression level is negatively correlated with language ability score(r=-0.188),T-AOC is positively correlated with attention score(r=0.231),there was no correlation with changes in oxidative stress indicators of T-SOD,MDA,GSH-Px,and CAT,the difference was not statistically significant(P>0.05).Conclusion Patients with first-episode schizophrenia had abnormal expression levels of peripheral blood oxidative stress indicators and cognitive function.Olanzapine could improve patients'cognitive impairment to a certain extent,but had no effect on oxidative emergency markers.At the same time,the expression level of oxidative stress markers in peripheral blood had no correlation with the cognitive dysfunction score of patients.Up-regulation of NO expression level and increased T-AOC capacity might be one of the pathogenesis of schizophrenia.