精神分裂症HCY、PRL及炎性因子与认知功能的相关性及疗效分析

Correlation and treatment of HCY,PRL,inflammatory factors and cognitive function in schizophrenia

目的探究精神分裂症患者脑部代谢激素同型半胱氨酸(homocysteine,HCY)、催乳素(prolactin,PRL)与认知功能的相关性,挖掘重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合奥氮平治疗该病的效果,以期解读脑部代谢激素与认知功能的影响机制,同时,挖掘rTMS联合奥氮平这种内外结合治疗方式来丰富该领域研究,为相关研究提供借鉴。方法选取2021年6月至2023年8月笔者医院治疗的128例精神分裂症患者资料进行回顾性分析,根据治疗方式的不同划分为观察组72例(rTMS联合奥氮平治疗)和对照组56例(奥氮平单药治疗)。分析两组患者血清HCY、PRL、阳性和阴性综合征量表(positive and negative syndrome scale,PANSS)、白细胞介素(interleukin,IL)-12,肿瘤坏死因子(tumor necrosis factor,TNF)-α及其相关性。比较两组患者不良反应发生率情况。结果治疗后,观察组PRL、HCY、IL-12、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。交互作用、时点作用、组间作用下,两组患者的PANSS评分会因为不同治疗方式的时间推移而发生变化,但观察组均低于对照组,差异有统计学意义(P<0.05)。治疗方法与HCY、PRL、IL-12、TNF-α、PANSS均呈负相关,且HCY、PRL、IL–12、TNF–α、PANSS两两间为正相关(P<0.05)。观察组头痛、记忆受损、嗜睡、不良反应事件等发生率低于对照组,差异有统计学意义(P<0.05)。结论经rTMS联合奥氮平治疗后,可以降低精神分裂症患者HCY、PRL激素水平,减轻炎症,减少不良反应,改善患者认知功能。

Objective To explore the brain metabolic hormone homocysteine in patients with schizophrenia homocysteine(HCY),prolactin(PRL)in its correlation with cognitive function,mining of repetitive transcranial magnetic stimulation(rTMS)combined with olanzapine for the disease,in order to interpret the influence mechanism of brain metabolic hormones and cognitive function,at the same time,mining rTMS and olanzapine to enrich research in this field,to provide reference for related studies.Methods The data of 128 schizophrenia patients treated in the hospital from June 2021 to August 2023 were selected for retrospective analysis,divided into the observation group 72 cases combined rTMS with olanzapine and the control group 56 cases(olanzapine monotherapy).Serum serum HCY,PRL,positive and negative syndrome scale(PANSS),interleukin(IL)-12,tumor necrosis factor(TNF)-αand their associations were analyzed in both groups.The incidence of adverse effects was compared between the two groups.Results After treatment,the levels of PRL,HCY,IL-12,and TNF-αin the observation group were lower than those of the control group,with significant and statistically significant differences(P<0.05).Under the interaction,time point and between groups,the PANSS scores of the two groups changed due to the time passage of different treatment methods,but the observation group was lower than the control group,with significant differences(P<0.05).Treatment was negatively associated with HCY,PRL,IL-12,TNF-α,and PANSS,and HCY,PRL,IL-12,TNF-α,and PANSS were positively associated(P<0.05).The incidence of headache,impaired memory,drowsiness,and adverse reaction events in the observed group was lower than that in the control group,and the difference was significant(P<0.05).Conclusion After rTMS combined with olanzapine treatment,schizophrenia patients can reduce HCY and PRL hormone levels,alleviate inflammation,reduce adverse reactions,and improve cognitive function.