利培酮联用叶酸对精神分裂症患者脑源性神经营养因子与炎性细胞因子的影响

Effects of risperidone combined with folic acid on brain-derived neurotrophin factor and inflammatory cytokines in patients with schizophrenia

目的观察利培酮联用叶酸对精神分裂症患者脑源性神经营养因子与炎性细胞因子的影响。方法85例首发精神分裂症患者,按照随机平行对照法分为对照组(42例)与研究组(43例)。对照组使用利培酮治疗,研究组使用叶酸+利培酮治疗。比较两组治疗前后炎性细胞因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、脑源性神经营养因子(BDNF)、同型半胱氨酸(Hcy)、精神分裂程度[阳性与阴性症状量表(PANSS)评分]、暴力行为[外显攻击行为量表(MOAS)评分]、认知功能[韦氏成人智力量表(WAIS-RC)评分]、社会功能[住院精神患者社会功能评定量表(SSPI)评分]。结果治疗3个月后,研究组患者的IL-6、TNF-α水平分别为(33.86±3.07)、(26.93±2.38)pg/ml,显著低于对照组的(38.15±3.56)、(32.67±2.93)pg/ml(P<0.05)。治疗3个月后,研究组的BDNF水平(593.18±56.02)pg/ml高于对照组的(527.46±49.37)pg/ml,Hcy水平(28.76±2.54)μmol/L低于对照组的(34.13±3.15)μmol/L(P<0.05)。治疗3个月后,研究组患者的PANSS、MOAS评分分别为(53.62±5.04)、(8.95±0.86)分,均显著低于对照组的(60.97±5.75)、(10.27±0.98)分(P<0.05)。治疗3个月后,研究组患者的WAIS-RC、SSPI评分分别为(206.91±17.85)、(33.25±3.01)分,均高于对照组的(185.26±15.37)、(28.07±2.54)分(P<0.05)。结论利培酮联用叶酸治疗精神分裂症,有利于改善BDNF与炎性细胞因子水平,减轻患者的临床症状和暴力行为,改善其认知功能和社会功能,具有较好的治疗效果。

Objective To observe the effects of risperidone combined with folic acid on brain-derived neurotrophin factor and inflammatory cytokines in patients with schizophrenia.Methods 85 patients with firstepisode schizophrenia were divided into a control group(42 patients)and a study group(43 patients)according to randomized parallel control method.The control group was treated with risperidone,while the study group was treated with folic acid and risperidone.Both groups were compared in terms of inflammatory cytokines[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],brain-derived neurotrophic factor(BDNF),homocysteine(Hcy),degree of schizophrenia[Positive and Negative Symptom Scale(PANSS)score],violent behavior[Modified Overt Aggression Scale(MOAS)score],and cognitive function[Wechsler Adult Intelligence Scale-Revised in China(WAIS-RC)score],and social function[Scale of Social Function in Psychosis Inpatients(SSPI)score].Results After 3 months of treatment,the levels of IL-6 and TNF-αin the study group were(33.86±3.07)and(26.93±2.38)pg/ml,which were significantly lower than(38.15±3.56)and(32.67±2.93)pg/ml in the control group(P<0.05).After 3 months of treatment,the study group had higher BDNF of(593.18±56.02)pg/ml than(527.46±49.37)pg/ml in the control group,and lower Hcy of(28.76±2.54)μmol/L than(34.13±3.15)μmol/L in the control group(P<0.05).After 3 months of treatment,the PANSS and MOAS scores of the study group were(53.62±5.04)and(8.95±0.86)points,which were significantly lower than(60.97±5.75)and(10.27±0.98)points of the control group(P<0.05).After 3 months of treatment,the WAIS-RC and SSPI scores of the study group were(206.91±17.85)and(33.25±3.01)points,which were higher than(185.26±15.37)and(28.07±2.54)points of the control group(P<0.05).Conclusion Risperidone combined with folic acid can improve the levels of BDNF and inflammatory cytokines,alleviate the clinical symptoms and violence of patients with schizophrenia,improve their cognitive function and social function,which has a better therapeutic effect.