分裂情感性精神病患者血清炎症因子和同型半胱氨酸水平与认知功能损害的相关性研究

Correlation of serum inflammatory factors,homocysteine levels and cognitive impairment in patients with schizo-affective psychosis

目的探究分裂情感性精神病患者血清炎症因子和同型半胱氨酸(Hcy)水平的变化与认知功能的相关性。方法选取55例分裂情感性精神病患者为观察组,55例无精神疾病的健康志愿者作为对照组,检测两组患者血清白细胞介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)和超敏C反应蛋白(hs-CRP)水平以及血清Hcy水平。采用阳性和阴性症状量表(PANSS)、持续性能测试(CPT)、威斯康星卡片分类测试(WCST)评估患者的认知功能。分析患者血清炎症因子与Hcy水平与认知功能损害的相关性。结果与对照组比较,观察组血清IL-1β、IL-6、TNF-α以及Hcy水平明显升高,而hs-CRP水平明显减少(t分别=7.74、4.48、3.24、6.94、13.38,P均<0.05)。血清炎症因子IL-1β与WCST持续错误数呈正相关(r=0.39,P<0.05),IL-6与PANSS阴性症状得分、PANSS总分、CPT干扰项错误数以及WCST连续错误数呈正相关(r分别=0.40、0.45、0.40、0.53,P均<0.05),TNF-α与PANSS阳性症状得分、PANSS总分、CPT干扰项错误数以及WCST连续错误数呈正相关(r分别=0.39、0.42、0.46、0.48,P均<0.05),hs-CRP与PANSS阴性症状得分、PANSS总分以及CPT干扰项错误数呈负相关(r分别=-0.38、-0.46、-0.44,P均<0.05);血清Hcy水平与PANSS阴性症状得分、CPT干扰项错误数、WCST随机错误数及连续错误数呈正相关(r分别=0.60、0.69、0.78、0.47,P均<0.05),与CPT准确反应数及WCST正确测试数呈负相关(r分别=-0.55、-0.62,P均<0.05)。结论分裂情感性精神病患者血清炎症因子和Hcy水平升高,且与患者认知功能具有一定的相关性,对临床上分裂情感性精神病的病情诊断和治疗具有指导意义。

Objective To explore the correlation between changes in serum inflammatory factors,homocysteine levels and cognitive function in patients with schizo-affective psychosis.Methods Totally 55 patients with schizo-affective psychosis were selected as the observation group,and 55 healthy volunteers without mental illness as the control group.The levels of serum interleukin-1β(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP),and homocysteamine were detected in the two groups.The cognitive function were assessed with posi-tive and negative symptom scale(PANSS),continuous performance test(CPT),and wisconsin card sorting test(WCST).The correlation of serum inflammatory factors and Hcy levels and cognitive impairment were analyzed.Results Com-pared with the control group,the levels of serum IL-1β,IL-6,TNF-αand Hcy in the observation group were significantly elevated,the level of hs-CRP was significantly reduced(t=7.74、4.48、3.24、6.94、13.38,P<0.05).The IL-1βwas positiv-ely correlated with WCST continuous error number(r=0.39,P<0.05),IL-6 was positively correlated with PANSS neg-ative symptom score,PANSS total score,CPT interference item error number and WCST continuous error number(r=0.40,0.45,0.40,0.53,P<0.05),TNF-αwas positively correlated with PANSS positive symptom score,PANSS total score,CPT interference item error number and WCST contin-uous error number(r=0.39,0.42,0.46,0.48,P<0.05),hs-CRP was negatively correlated with PANSS negative symptom score,PANSS total score and CPT interference item error number(r=-0.38,-0.46,-0.44,P<0.05),the level of serum Hcy was positively correlated with PANSS negative symptom score,CPT interference item error number and WCST random error number(r=0.60,0.69,0.78,0.47,P<0.05),and negatively correlated with CPT accurate response number and WCST correct test number(r=-0.55,-0.62,P<0.05).Conclusion The levels of serum inflammatory factors and homocysteine in patients with schizoaffective psychosis are elevated,and they have a certain correlation with the cognitive function of the patients,and have guiding significance for the diagnosis and treatment of clinical schizo-affective psychosis.