慢性精神分裂症患者胰岛素样生长因子-1、神经细胞黏附分子水平与临床症状的相关性及对认知障碍的诊断价值

Correlations of insulin-like growth factor-1 and neural cell adhesion molecule levels with clinical symptoms in patients with chronic schizophrenia and theiRdiagnostic value foRcognitive impairment

目的探讨慢性精神分裂症患者血清胰岛素样生长因子-1(IGF-1)、神经细胞黏附分子(NCAM)水平与临床症状的相关性及对认知障碍的诊断价值。方法将开滦总医院2017年5月—2018年11月收治的100例慢性精神分裂症患者纳入研究组,并根据中文版蒙特利尔认知评估量表(MoCA)评估结果分为认知障碍组(46例)和认知正常组(54例)。另选取100例健康者纳入对照组。观察比较各组间的血清IGF-1、NCAM水平、临床症状[阳性与阴性症状量表(PANSS)阳性症状、阴性症状、一般精神病理症状评分]。分析研究组患者血清IGF-1、NCAM水平与临床症状的相关性及对认知障碍的诊断价值。结果研究组IGF-1、NCAM水平均低于对照组,差异有统计学意义(P<0.05)。认知障碍组患者IGF-1、NCAM水平均低于认知正常组,PANSS评分高于认知正常组,差异有统计学意义(P<0.05)。研究组患者IGF-1、NCAM水平与PANSS阳性症状、阴性症状、一般精神病理症状评分及总评分均呈负相关(P<0.05);血清IGF-1、NCAM及两者联合对认知障碍诊断的敏感度依次为95.65%、89.13%、89.13%,特异性依次为81.48%、88.89%、98.15%,曲线下面积(AUC)依次为0.936、0.947、0.955。结论慢性精神分裂症患者的血清IGF-1、NCAM水平降低,与临床症状严重程度呈负相关,且两者对患者认知功能变化具有重要的诊断意义。

Objective To investigate the correlation of serum insulin-like growth factor-1(IGF-1),neural cell adhesion molecule(NCAM)levels with clinical symptoms in patients with chronic schizophrenia and theiRdiagnostic value foRcognitive impairment.Methods A total of 100 patients with chronic schizophrenia who admitted to Kailuan General Hospital from May 2017 to NovembeR2018 were included in study group,and were divided into cognitive impairment group(n=46)and normal cognition group(n=54)according to the Chinese version of Montreal Cognitive Assessment(MoCA)Scale.AnotheR100 healthy subjects were included in control group.Serum IGF-1 and NCAM levels,clinical symptoms[positive and negative symptom scale(PANSS)positive symptoms,negative symptoms,general psychopathological symptom scores]were observed and compared between the groups.Correlation of serum IGF-1 as well as NCAM levels with clinical symptoms and theiRdiagnostic value foRcognitiveimpairment in the study group.Results The levels of IGF-1 and NCAM in the study group were significantly loweRthan those in the control group(P<0.05).The levels of IGF-1 and NCAM in the cognitive impairment group were significantly lower,and the PANSS score was significantly higheRthan that in the normal cognition group(P<0.05).The levels of IGF-1 and NCAM in the study group were negatively correlated with the PANSS positive symptoms,negative symptoms,general psychopathological symptom scores and total scores(P<0.05);the sensitivity of serum IGF-1,NCAM and theiRcombination in the diagnosis of cognitive impairment was 95.65%,89.13%and 89.13%,respectively,the specificity was 81.48%,88.89%and 98.15%,respectively,and the area undeRthe curve(AUC)was 0.936,0.947 and 0.955,respectively.Conclusion The serum levels of IGF-1 and NCAM in patients with chronic schizophrenia are negatively correlated with the severity of clinical symptoms,and they have important diagnostic significance foRthe changes of cognitive function in patients.