维生素D3辅助治疗对首发精神分裂症患者血清神经营养因子、氧化应激指标及临床疗效的影响

Effects of Vitamin D3 on serum neurotrophic factors and oxidative stress in patientswith first-episode schizophrenia

目的:探讨维生素D3(VD3)辅助治疗对首发精神分裂症患者血清神经营养因子、氧化应激指标及临床疗效的影响。方法:将120例首发精神分裂症患者随机分为两组,且均给予利培酮治疗16周;在此基础上,干预组加服VD3(800 IU/d),对照组每日服用安慰剂。根据治疗前后阳性与阴性症状量表(PANSS)评分来判断疗效;治疗前后检测血清25-羟基维生素D3[25-(OH)D3]、脑源性神经生长因子(BDNF)和神经生长因子(NGF)水平;氧化应激指标,包括超氧化物歧化酶(T-SOD)、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)、过氧化氢酶(CAT)及总抗氧化能力(T-AOC)。结果:16周治疗后,两组PANSS评分较治疗前显著降低,且干预组PANSS总分、阴性症状评分较对照组显著降低(P均<0.05);干预组血清中25-(OH)D3、NGF、GSH-PX、SOD、T-AOC水平明显高于治疗前及对照组(P<0.05或P<0.01)。结论:应用VD3辅助治疗能提高首发精神分裂症患者血清25-(OH)D3、NGF水平、改善氧化应激状态;具有抗精神病药的增效作用。

Objective:To explore the effect of vitamin D3 on serum neurotrophic factors、oxidative stress indexes and clinical efficacy in first-episode schizophrenia.Method:A total of 120 patients with first-episode schizophrenia were selected and divided into control group(60 cases)and treatment group(60 cases).All patients were randomized to receive 16-week treatment of risperidone with either 800IU VitD3 capsule(treatment group)or placebo(control group).The levels of serum 25-hydroxyvitamin D3(25-(OH)D3),Serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF)of two groups were determined before and after treatment.Oxidative stress parameters such as Superoxide dismutase(T-SOD),glutathione peroxidase(GSH-PX),malondialdehyde(MDA),catalase(CAT)and total antioxidant capacity(T-AOC)were measured in two groups before and after treatment.The positive and negative syndrome scale(PANSS)and treatment emergency symptom scale(TESS)scales were used to assess the change of clinical psychiatric symptoms and adverse effects.Results:After 16 weeks of treatment,PANSS scores were significantly lower in both groups than before treatment,and PANSS total scores and negative symptom scores were significantly lower in the intervention group compared to the control group(P<0.05).Serum levels of 25-(OH)D3,NGF,GSH-PX,SOD,and T-AOC in the intervention group were significantly higher than those in the pre-treatment and control groups(P<0.05 or P<0.01).Conclusion:Vitamin D3 intervention can effectively improve patients'PANSS score and participate in the adjuvant treatment of first-episode schizophrenia.The reason may be related to the increase of serum NGF levels and the improvement of oxidative stress.