首发精神分裂症患者心肌酶谱变化及临床意义

Changes of myocardial enzymes and their clinical significance in patients with first episode schizophrenia

目的观察首发精神分裂症(SZ)患者心肌酶谱变化及临床意义。方法选取2018年2月~2019年11月本院收治的精神分裂症患者100例,按照精神分裂症阳性和阴性症状量表(PANSS)分为阳性症状组和阴性症状组,另选取本院同期体检健康职工32例,作为健康组。分别于治疗前和治疗4周后采集SZ患者外周血4 mL,健康组患者于体检时抽取,检测样本乳酸脱氢酶(LDH)、肌酸激酶(CK)、天门冬氨酸氨基转移酶(AST)水平,对SZ患者治疗前后、SZ患者与健康组血清心肌酶谱水平进行比较分析。结果阳性症状组治疗前、治疗后血清LDH、CK、AST水平显著高于阴性症状组(P<0.05);治疗后两组患者血清LDH、CK、AST水平均低于治疗前(P<0.05);Spearman秩相关分析结果显示,SZ患者血清LDH、CK、AST水平与阳性症状量表得分具有相关性(P<0.05);治疗前SZ患者血清LDH、CK、AST水平显著高于健康组(P<0.05);血清CK诊断SZ的曲线下面积(AUC)最大,敏感度和特异度显著优于LDH、AST(P<0.05)。结论首发精神分裂症患者心肌酶谱存在异常增高现象,血清LDH、CK、AST水平与SZ患者阳性症状有相关性,CK对SZ的临床诊断具有一定的参考价值。

Objective To observe the changes of myocardial enzymes and their clinical significance in patients with first episode schizophrenia(SZ).Methods A total of 100 patients with schizophrenia admitted to our hospital from February 2018 to November 2019 were selected.According to the schizophrenia positive and negative symptoms scale(PANSS),they were divided into the positive symptom group and the negative symptom group.In addition,32 healthy employees who underwent physical examination during the same period in our hospital were selected as the healthy group.The peripheral blood in SZ patients with 4 mL was collected respectively before and after 4 weeks of treatment.The blood of healthy group was collected during medical examination.The levels of lactate dehydrogenase(LDH),creatine kinase(CK),and aspartate aminotransferase(AST)were detected.The serum myocardial zymogram level in patients with SZ patients and healthy group before and after treatment were analyzed.Results Serum LDH,CK and AST were significantly higher in the positive symptom group than in the negative symptom group before and after treatment(P<0.05).After treatment,serum LDH,CK and AST levels in both groups were lower than those before treatment(P<0.05).Spearman rank correlation analysis showed that serum LDH,CK and AST levels in SZ patients were correlated with the score of positive symptom scale(P<0.05).Serum LDH,CK and AST levels of SZ patients were significantly higher than those of the healthy group before treatment(P<0.05).The area under the curve(AUC)of serum CK in SZ diagnosis was the largest,and the sensitivity and specificity were significantly better than those of LDH and AST(P<0.05).Conclusion There is an abnormal increase in myocardial enzyme spectrum in patients with first episode schizophrenia.Serum LDH,CK and AST are correlated with positive symptoms in SZ patients,and CK has certain reference value for clinical diagnosis of SZ.