血清皮质醇、5-羟色胺、炎症因子、蛋白因子水平与精神分裂症病情的相关性研究

Correlation of serum levels of cortisol,serotonin,inflammatory factors and protein factors with severity of schizophrenia

目的探讨血清皮质醇、5-羟色胺(5-HT)、炎症因子、蛋白因子水平与精神分裂症病情严重程度的相关性。方法选取2017年8月至2019年12月舟山市第二人民医院收治的65例精神分裂症患者为观察组,同期经治疗后临床症状得到有效控制[阳性和阴性症状量表(PANSS)阳性症状中妄想、概念紊乱、幻觉、猜疑/迫害评分均≤5分(轻度)且稳定期≥3个月]的69例精神分裂症患者为对照组。比较两组患者PANSS评分以及血清皮质醇、5-HT、炎症因子、蛋白因子水平,同时分析两者的相关性。结果与对照组比较,观察组患者PANSS阴性量表、阳性量表、复合量表及总分均明显升高(均P<0.05),血清皮质醇水平、TNF-α、IL-1β、IL-6、IL-12、S100β均明显升高(均P<0.05),5-HT、髓鞘碱性蛋白(MBP)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平均明显降低(均P<0.05);但两组患者血清神经胶质纤维酸性蛋白(GFAP)水平比较,差异无统计学意义(P>0.05)。观察组血清皮质醇、5-HT、TNF-α、IL-1β、IL-6、IL-12、GFAP、MBP、NGF、BDNF、NGF与PANSS总分均呈正相关(r=0.213、0.287、0.291、0.256、0.276、0.219、0.275、0.294、0.271、0.281、0.245,均P<0.05)。结论血清皮质醇、5-HT、炎症因子、蛋白因子水平与精神分裂症病情严重程度均呈正相关,可为精神分裂症的临床诊断、治疗指导及预后评估提供参考。

Objective To investigate the correlation of serum levels of cortisol,5-hydroxytryptamine(5-HT),inflammatory factors and protein factors with the severity of schizophrenia.Methods Sixty-five patients with schizophrenia admitted to Zhoushan Second People's Hospital from August 2017 to December 2019 were enrolled as study group,69 schizophrenic patients whose clinical symptoms were effectively controlled after treatment during the same period were selected as control group.The positive and negative symptom scale(PANSS)score and the levels of serum cortisol,5-HT,inflammatory factors,and protein factors were compared between the two groups.Results Compared with the control group,the PANSS negative scale,positive scale,composite scale and total score of the study group were significantly increased(all P<0.05),and the serum cortisol levels,TNF-α,IL-1β,IL-6,IL-12 and S100βwere significantly elevated(all P<0.05),and 5-HT,myelin basic protein(MBP),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF)levels were significantly reduced(all P<0.05).However,there was no significant difference in the serum glial fibrillary acidic protein(GFAP)levels between the two groups(P>0.05).Serum levels of cortisol,5-HT,TNF-α,IL-1β,IL-6,IL-12,GFAP,MBP,NGF,BDNF,NGF were all positively correlated with PANSS total score in study group(r=0.213,0.287,0.291,0.256,0.276,0.219,0.275,0.294,0.271,0.281,0.245,all P<0.05).Conclusion The levels of serum cortisol,5-HT,inflammatory factors,and protein factors are positively correlated with the severity of schizophrenia,indicating that these serum indicators may provide references for clinical diagnosis,treatment guidance and prognostic evaluation of schizophrenic patients.