氯氮平治疗对以阳性或阴性症状为主的精神分裂症患者血清一氧化氮含量的影响

Serum nitric oxide level in positive and negative schizophrenia and its clinical significance

目的 探讨以阳性症状为主 (以下简称阳性 )或阴性症状为主 (以下简称阴性 )的精神分裂症患者用氯氮平治疗前后血清一氧化氮 (NO)含量变化及其与疗效的关系。方法 对 32例阳性患者、30例阴性患者均用氯氮平 (30 0mg/d)治疗 8周。用阳性症状评定量表 (SAPS)和阴性症状评定量表 (SANS)评定其疗效。治疗前及治疗第 8周末分别检测血清NO含量 ,并与 2 8名健康志愿者 (对照组)比较。结果 治疗前阳性组、阴性组及对照组血清NO含量分别为 :(5 9± 16 ) μmol/L、(2 6± 7) μmol/L和 (38± 11) μmol/L ,三组间的差异有非常显著性 (P <0 0 1)。治疗前阳性组血清NO含量与SAPS总分呈显著正相关 (r =0 6 92 ,P <0 0 1) ;阴性组血清NO含量与SANS总分呈显著负相关(r=- 0 916 ,P <0 0 1)。治疗第 8周末阳性组血清NO含量降低至 (39± 8) μmol/L ,其NO降低值与SAPS减分率之间呈显著正相关 (r=0 86 8,P <0 0 1) ;阴性组血清NO含量升高至 (32± 8) μmol/L ,显著高于治疗前 (P <0 0 5 ) ,但仍低于对照组 (P <0 0 1)。NO升高值与SANS减分率呈负相关(r=- 0 916 ,P <0 0 1)。结论 以阳性症状为主与以阴性症状为主的精神分裂症患者血清NO含量的差异有显著性 ;患者血清NO含量变化与疗效之间高度相关。

ObjectiveTo explore the changes of serum nitric oxide (NO) level after clozapine therapy in schizophrenics with positive or negative symptoms. MethodsThirty-two schizophrenics with positive symptoms and 30 with negative symptoms were treated with clozapine for 8 weeks. All patients were assessed with the Scale for Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS). The serum NO levels were measured before and after treatment and compared with 28 normal controls. ResultsThe serum NO levels in patients with positive symptoms, with negative symptoms and normal controls were significantly different [(59±16), (26±7), and (38±11)μmol/L, respectively; P <0.01]. The serum NO level in positive patients was positively correlated to the total score of SAPS ( r =0.692, P <0.01), but negatively to the total score of SANS in negative patients ( r =-0.916, P <0.01). The serum NO level in positive patients was decreased after 8-week treatment (39±8) μmol/L, and the decreased value positively correlated to the reduced rate of SAPS score ( r =0.868, P <0.01). The serum NO level after treatment in negative patients was higher (32±8) μmol/L than baseline ( t =2.398, P <0.05), but still lower than that in controls ( t =2.679, P <0.01), and the increased value positively correlated with the reduced rate of SANS score. Conclusions The serum NO level may be different in positive and negative schizophrenia both before and after treatment with clozapine. There is significant relationship between the serum NO level and the effects of clozapine.