首发精神分裂症患者治疗前后血清Hcy、BDNF水平与认知功能的关系分析

Relationship between serum Hcy and BDNF levels and cognitive function in patients with first-episode schizo⁃phrenia before and after treatment

目的分析首发精神分裂症患者治疗前后血清同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)水平与认知功能的关系。方法选取首发精神分裂症患者120例(精神分裂症组)及同期健康志愿者50例(对照组),测定血清Hcy、BDNF水平,以精神分裂症认知功能测试共识版(MCCB)评估认知功能,比较精神分裂组患者与对照组血清Hcy、BDNF水平与认知功能差异,并比较精神分裂组患者治疗前后血清Hcy、BDNF水平与认知功能变化,分析Hcy、BDNF水平与认知功能的关系。结果治疗前,精神分裂症组血清Hcy水平高于对照组(t=-19.22,P<0.05),BDNF低于对照组(t=20.20,P<0.05);精神分裂症组连线测试、符号编码、言语学习、空间广度、迷宫、视觉空间记忆、语义流畅性、情绪管理、持续操作得分均低于对照组(t分别=4.25、6.86、8.97、13.54、11.96、2.49、9.88、2.92、29.01,P均<0.05);精神分裂症组治疗第8周Hcy、BDNF无明显变化(t分别=1.48、1.59,P均>0.05),治疗第12周Hcy水平低于治疗前及治疗第8周(t分别=65.10、64.56,P均<0.05),BDNF高于治疗前及治疗第8周(t分别=45.07、43.20,P均<0.05);精神分裂症组治疗第8周、第12周MCCB中各项得分均低于治疗前(t分别=10.04、10.94、13.88、27.72、22.49、20.13、26.56、9.79、14.30;25.37、32.60、40.91、54.47、44.21、49.12、38.66、17.94、32.13,P均<0.05);首发精神分裂症患者Hcy与MCCB中连线测试、符号编码、言语学习、空间广度、情绪管理、持续操作呈负相关(r分别=-0.68、-0.49、-0.54、-0.71、-0.68、-0.80,P均<0.05),BDNF与连线测试、言语学习、空间广度、情绪管理呈正相关(r分别=0.47、0.50、0.61、0.57,P均<0.05)。结论首发精神分裂症患者血清Hcy水平与其认知功能在治疗前后发生变化,且Hcy、BDNF水平与连线测试、符号编码、言语学习、空间广度、情绪管理、持续操作等认知功能损害有一定相关性。

Objective To analyze the relationship between serum homocysteine(Hcy)and brain-derived neurotrophic factor(BDNF)levels and cognitive function in patients with first-episode schizophrenia before and after treatment.Methods A total of 120 patients with first-episode schizophrenia(schizophrenia group)and 50 healthy volunteers(control group)were included in this study.Serum Hcy and BDNF levels were measured.The MATRICS consensus cogni⁃tive battery(MCCB)was used to evaluate cognitive function.The changes of serum Hcy and BDNF levels,and cognitive function in the schizophrenia group were analyzed.The relationship between Hcy and BDNF levels and cognition function was analyzed.Results Before treatment,the schizophrenia group had higher serum Hcy level and lower BDNF level than the control group(t=-19.22,20.20,P<0.05).Compared with the control group,the schizophrenia group had lower scores of trail making test,symbol coding,language learning,spatial extent,maze,visual spatial memory,semantic fluen⁃cy,emotional management and continuous operation(t=4.25,6.86,8.97,13.54,11.96,2.49,9.88,2.92,29.01,P<0.05).There was no significant change of Hcy or BDNF in the schizophrenia group at the 8th week of treatment(t=1.48,1.59,P>0.05),but the Hcy level was lo⁃wer and BDNF level was higher at the 12th week of treatment than before treatment and the 8th week of treatment(t=65.10,64.56,45.07,43.20,P<0.05).The MCCB scores of schizophrenia group at the 8th and 12th weeks of treatment were lower than those before treatment(t=10.04,10.94,13.88,27.72,22.49,20.13,26.56,9.79,14.30;25.37,32.60,40.91,54.47,44.21,49.12,38.66,17.94,32.13,P<0.05).Hcy in patients with schizophrenia was negatively correlated with trail making test,symbol coding,language learning,spa⁃tial extent,emotional management and continuous operation in the MCCB(r=-0.68,-0.49,-0.54,-0.71,-0.68,-0.80,P<0.05).BDNF was positively correlated with trail making test,language learning,spatial extent and emotional manage⁃ment(r=0.47,0.50,0.61,0.57,P<0.05).Conclusion Serum Hcy levels and cognitive function in patients with firstepisode schizophrenia have changed after treatment.Hcy and BDNF levels are correlated with trail making test,symbol coding,language learning,spatial extent,emotional management and continuous operation.