难治性强迫障碍患者认知功能和血浆C反应蛋白水平的关联

Association of cognitive function,plasma C-reactive protein level in patients with treatment-resistant obsessive-compulsive disorder

目的:分析难治性强迫障碍(trOCD)患者的认知功能、临床症状与血浆C-反应蛋白(CRP)水平的关系。方法:纳入55例trOCD和45例非难治强迫障碍(non-trOCD)患者及65名正常对照。采用Yale-Brown强迫量表、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、MATRICS共识认知成套测验(MCCB)等评估强迫、抑郁焦虑症状和认知功能,以免疫胶乳比浊法检测被试血浆CRP水平。结果:与其他组相比,trOCD组MCCB总分及信息处理速度、工作记忆、推理及问题解决能力较低,血浆CRP水平和高CRP患者比例(≥3 mg/L)较高(均P<0.05);non-trOCD不同CRP组间MCCB各维度差异无统计学意义(均P>0.05)。Logistic回归分析显示,难治性风险因素有强迫症状多(OR=2.01)、严重程度高(OR=2.29)、MCCB总分低(OR=4.01)、血浆CRP水平高(OR=4.24)、病程长(OR=3.23)(P<0.05)。结论:trOCD患者认知功能下降、血浆CRP水平升高,与强迫症状多、严重程度高和病程长关联。

Objective:To evaluate the association of cognitive function,clinical symptoms,and plasma C-reac-tive protein(CRP)level in patients with treatment-resistant obsessive-compulsive disorder(trOCD).Methods:Fif-ty-five patients with trOCD,45 patients with non-trOCD,and 65 normal controls were enrolled.The Yale-Brown Obsessive-Compulsive Scale(YBOCS),Hamilton depression scale,Hamilton anxiety scale,MATRICS Consensus Cognitive Battery(MCCB)were used to evaluate the OCD,depressive or anxious clinical symptoms,as well as cognitive function,in above-mentioned subjects.The plasma CRP level were examined by using the latex-enhanced immunoturbidimetry methods in three groups.Results:Compared with the other two groups,the MCCB cognition scores,especially information processing speed,working memory,inferential knowledge and problem-solving skills were higher in the trOCD group,respectively(Ps<0.05).The plasma CRP level and percentage of cases with high CRP level(≥3 mg/L)in the trCOD group were higher than those in other two groups(P<0.05).However,difference of MCCB and its factorial scores revealed no statistical significances in non-trOCD group(Ps>0.05).Logistic regression analysis showed that potential risk factors of treatment-resistant OCD including,more obsessive-compulsive symptoms(OR=2.01),higher severity of OCD(OR=2.29),lower MCCB total scores(OR=4.01),higher plasma CRP level(OR=4.24),and longer disease course of OCD(OR=3.23)(P<0.05).Conclusion:Impaired cognitive function,high plasma C-reactive protein level,may be associated with more obsessive-compul-sive symptoms,higher severity of OCD,as well as long disease course of OCD.