精神分裂症首次发病患者弓形虫感染率及其对临床症状的影响  

Survey on Toxoplasma infection in first-episode schizophrenia and its influence on the clinical manifestation of schizophrenia

作　　者：王惠玲[1] 李秋英[1] 王高华[1] 舒畅[1] 王晓萍[1] 刘浩[1] 段金莲[1] 杨相升[2] 

机构地区：[1]武汉大学人民医院精神科,430060 [2]武汉大学人民医院检验科,430060

出　　处：《中华精神科杂志》2005年第3期134-137,共4页Chinese Journal of Psychiatry

基　　金：美国Stanley医学研究基金会资助项目(01T435)

摘　　要：目的探讨弓形虫感染与精神分裂症发病的关系,调查精神分裂症首次发病(以下简称首发)患者及其母亲弓形虫抗体阳性率,了解弓形虫抗体阳性与阴性患者在临床症状上的异同。方法采用酶联免疫吸附法,检测600例首发精神分裂症患者(患者组)、252例患者的母亲(患者母亲组)、正常对照组(200名)和非精神疾病的疾病对照组(200例)血清弓形虫抗体水平,并对患者组进行阳性和阴性症状量表评定。结果(1)IgG和IgM抗体阳性率,患者组分别为13.7%和5.3%,高于合并对照组(即正常对照组合并疾病对照组;分别为3.8%和2.8%;P<0.01和P<0.05);患者母亲组分别为19.4%和9.1%,高于患者组和合并对照组(P<0.01和P<0.05)。(2)弓形虫抗体阳性组患者的母亲IgG和IgM抗体阳性率分别为34.8%和17.4%,高于阴性组患者的母亲(分别为16.0%和7.3%;P<0.01和P<0.05)。(3)阳性组患者在兴奋、敌对、装相和作态、意志障碍、冲动控制障碍、愤怒、延迟满足困难等项目的得分均高于阴性组(P<0.01),猜疑/被害得分低于阴性组(P<0.01)。(4)阳性组患者病程的中位数和四分位数(P25,P75)分别为3(1,9)个月,短于阴性组患者4(2,10)个月(P<0.05)。结论弓形虫感染在首发精神分裂症患者中占有一定的比例,且弓形虫感染阳性患者的临床表现不同于未感染者,弓形虫感染可能与精神分裂症的发病有关。Objective To survey the prevalence of antibodies to Toxoplasma gondii （T. gondii） in patients with first-episode schizophrenia and their mothers, and explore the difference in clinical symptoms between seropositive and seronegative patients. Methods Six hundred cases with first-episode schizophrenia and 252 mothers, 200 non-psychotic controls, and 200 normal controls were recruited. The serum antibodies to T. gondii were measured with enzyme linked immunosorbent assay （ELISA）. And the clinical symptoms in the schizophrenic patients were assessed with the Positive and Negative Syndrome Scale （PANSS）. Results The rates of positive IgG and IgM class antibody in the patients＇ mothers were 19. 4% and 9. 1% respectively, which were higher than that in the patients （ 13.7% and 5.3% respectively）, and the positive rates were lowest in the controls. Compared with the seronegative patients, the seropositive patients＇ mothers had higher rate of seropositivity to T. gondii. The clinical symptoms in the seropositive patients were statistically different from the seronegative ones in excitation, hostility, mannerisms and posturing,disturbance of volition, poor impulse control and anger, difficult to delay fulfilling request and suspiciousness, and the illness course of the seropositive patients was statistically shorter than that of the seronegative ones. Conclusion The results suggest that Toxoplasma infection is possibly an important candidate etiological factor of schizophrenia, and it may influence the clinical manifestation of schizophrenia.

关 键 词：精神分裂症 弓形虫病 抗体 疾病特征 首发精神分裂症患者 弓形虫感染率 阴性患者 首次发病 临床症状 抗体阳性率 正常对照组 酶联免疫吸附法 阳性和阴性症状 患者母亲 

分 类 号：R749.3[医药卫生—神经病学与精神病学]