精神分裂症患者血清C-反应蛋白水平与其临床症状的关系

Relationship between serum C-reactive protein level and clinical symptoms in patients with schizophrenia

目的:探讨精神分裂症患者血清C反应蛋白(CRP)水平与临床症状的关系。方法:收集117例精神分裂症患者一般人口学资料及临床资料;采用阳性与阴性症状量表(PANSS)和汉密尔顿抑郁量表(HAMD)分别评估患者的精神症状和抑郁症状,HAMD≥17定义为抑郁障碍;检测入组者的糖脂代谢指标评估代谢综合征(MS)的发生率;检测血清CRP水平,并据此将入组者分为CRP正常组(CRP≤3.0 mg/L)和CRP升高组(CRP>3.0 mg/L);分析血清CRP水平与患者临床情况的关系。结果:117例患者中,29例(24.79%)伴发抑郁障碍;33例(28.21%)伴发MS;47例归入CRP正常组,70例归入CRP升高组。与CRP正常组比较,CRP升高组中抑郁障碍及MS发生率明显增高;PANSS的阳性因子分、抑郁因子分及HAMD评分明显增高(P<0.05或P<0.01)。Logistic回归分析显示,血清CRP水平增高与PANSS阳性因子分和抑郁因子分、HAMD评分、MS发生率呈正相关(P<0.05或P<0.01)。结论:约60%的精神分裂症患者出现血清CRP水平增高,血清CRP水平增高与患者较重临床精神症状、伴发抑郁症状及代谢指标紊乱具有相关性。

Objective:To investigate the relationship between serum C-reactive protein(CRP)level and clinical symptoms in patients with schizophrenia.Method:The general demographic and clinical data of 117 patients with schizophrenia were collected.The Positive and Negative Symptom Scale(PANSS)and Hamilton Depression Scale(HAMD)were used to evaluate the mental symptoms and depressive symptoms with depression defined as HAMD≥17.The indexes of glucose and lipid metabolism were detected to evaluate the incidence of metabolic syndrome(MS).The level of serum CRP was detected,and participants were divided into normal CRP group(CRP≤3.0 mg/L)and elevated CRP group(CRP>3.0 mg/L)according CRP level.The relationship between serum CRP level and clinical situation was analyzed.Results:Among 117 patients,29 cases(24.79%)were accompanied by depression,33 cases(28.21%)were accompanied by MS,47 cases were classified as normal CRP group and 70 cases were classified as elevated CRP group.Compared with normal CRP group,the incidence of depression and MS in elevated CRP group was significantly higher.The positive factor score,depression factor score of PANSS and HAMD score were significantly higher(P<0.05 or P<0.01).Logistic regression analysis showed that the increase of serum CRP level was related to the increase of PANSS positive factor score,depression factor score,HAMD score and the incidence of MS(P<0.05 or P<0.01).Conclusion:About 60%of schizophrenic patients have increased serum CRP level.The increased serum CRP level is correlated with severe clinical psychiatric symptoms,accompanying depressive symptoms and metabolic index disorders.