利培酮及氯氮平对儿童精神分裂症血清α-肿瘤坏死因子的影响  

The effect of Risperidone and Clozapine on the plasma tumor necrosis factor(TNFα) level in children with schizophrenia

作　　者：成军[1] 郭素芹[1] 郭敬华[1] 李强[1] 李红[1] 杜海霞[1] 郭芳[1] 

机构地区：[1]河南省精神病医院儿童精神科,新乡453002

出　　处：《中国神经精神疾病杂志》2006年第1期43-45,共3页Chinese Journal of Nervous and Mental Diseases

基　　金：河南省自然科学基金资助项目(编号:0123030400)

摘　　要：目的了解抗精神病药物对儿童精神分裂症患者血清a肿瘤坏死因子(TNFα)的影响,并探讨TNFα与精神病理之间的关系。方法采用酶联免疫吸附法检测74例儿童首发精神分裂症患者药物治疗前后及36例正常儿童的血清TNFα水平,同时采用阳性和阴性症状量表(PANSS)评估患者精神症状及其变化。结果精神分裂症患者治疗前TNFα水平显著高于对照组(t=3.08,P<0.01),治疗后4周末及8周末与对照组比较均无显著性差异(t=0.11,0.52,P>0.05),均较治疗前显著降低(P<0.05,P<0.01)。治疗前及治疗后4周末血清TNFα水平与对应PANSS总分及各因子分无显著相关(P>0.05),治疗后8周末TNFα与阳性症状分及总分呈正相关。治疗后4周末TNFα变化率与阴性症状分减分率、一般病理分减分率及总分减分率呈正相关,治疗后8周末TNFα变化率与阳性症状分减分率呈正相关;利培酮组患者TNFα水平治疗后4周末无显著变化,治疗后8周末显著低于治疗前(P<0.05);氯氮平组患者治疗后4周末及8周末均显著低于治疗前(P<0.01)。治疗后4周末血清TNFα变化率与氯氮平日剂量呈显著正相关(P<0.05),利培酮日剂量与TNFα变化率无相关,8周末两药日剂量与TNFα变化率均无相关。结论抗精神病药物对儿童精神分裂症患者血TNFα有抑制作用,血清TNFα水平与精神病理之间有着一定关系。Objective To explore the effect of antipsychotic drugs on the plasma tumor necrosis factor（TNFα） level and the relationship hetween psychopathology and TNFα in children with schizophenia. Method The TNFα level on 74 patients with first episode schizophrenic was measured with ELISA method before and after treatment with antipsyehotic drugs comparing with 36 healthy children controls. The symptoms were evaluated with Positive and Negative Syndrom Scale （PANSS）. Results Before treatment , the TNFet in schizophrenia was much higher than that in control group （P 〈 0. 01 ） , but was no noted difference at the end of 4^th, 8^th week after treatment （ P 〉 0. 05 ） . The levels of TNFet at the end of 4^th, 8^th weeks were significantly lower than those before treatment（P 〈0.05, P 〈0.01 ）. There was no relevance for TNFα and total score of PANSS and every factor score between before treatment and at the end of 4^th week after treatment （ P 〉 0. 05 ）, but at the end of 8^th week after treatment the TNFα was relevant to positive symptoms and total score . The changed rate of TNFα at the end of 4^th week after treatment was positively correlated with the reduced rate of negative symptoms, the reduced rate of general pathology and total . The changed rate of TNFα at the end of 8^th week after treatment was positively correlated with the reduced rate of positive symptoms. There was no noted change for TNFet in patient with Risperidone at the end of 4^th week, but was much lower at the 8^th week than before treatment. TNFα in patients with Clozapine at the end of 4^th ,8^th week after treatment was much lower than before treatment. At the end of 4^th week after treatment, the changed rate of TNFα was positively correlated with daily dose of Clozapine, but was not correlated with daily dose of Risperidone. At the end of 8^th week, daily dose of both medicine had no relevance to the changed rate of TNFα. Conclusion Antipsyehotie drugs have suppressive function on plasma TNFα of children

关 键 词：精神分裂症 利培酮 氯氮平 Α-肿瘤坏死因子 儿童 

分 类 号：R749.3[医药卫生—神经病学与精神病学]