精神分裂症免疫指标与精神症状的关系  

Changes of immunological parameters in chronic schizophrenia before and after neuroleptic treatment

作　　者：张向阳[1,2] 周东丰[1,2] 张培琰 苏建民[1,2] 成秀芳 张华远[1,2] 赵玉华 南振国[1,2] 崔勇 刘津[1,2] 高士元 朱艺兰 阮燕[1,2] 孙丽丽 管振全[1,2] 

机构地区：[1]北京医科大学精神卫生研究所 [2]北京回龙观医院

出　　处：《中华精神科杂志》1997年第3期145-148,共4页Chinese Journal of Psychiatry

摘　　要：为探讨精神分裂症精神病理与免疫指标的相关性、评估抗精神病药对免疫指标的影响及其与疗效的关系，用固定剂量氟哌啶醇治疗５０例慢性精神分裂症患者１２周，在治疗前后测查Ｔ细胞亚群和白细胞介素２（ＩＬ－２）分泌细胞，并采用简明精神病评定量表（ＢＰＲＳ）、阳性症状评定量表（ＳＡＰＳ）和阴性症状评定量表（ＳＡＮＳ）进行评定。结果显示，治疗前ＣＤ３阳性细胞（ＣＤ＋３）、ＣＤ４阳性细胞（ＣＤ＋４）、ＣＤ４／ＣＤ８阳性细胞比值（ＣＤ４／ＣＤ８）和ＩＬ－２分泌细胞均明显低于正常人，治疗后ＣＤ＋４呈显著性增高；治疗前ＣＤ４／ＣＤ８与ＳＡＰＳ总分呈显著负相关，ＢＰＲＳ、ＳＡＰＳ和ＳＡＮＳ减分率与治疗前ＣＤ＋３细胞数均呈显著正相关，ＳＡＮＳ减分率与治疗前ＣＤ＋４细胞数亦呈正相关。研究表明，抗精神病药在改善患者精神症状的同时，也使其免疫功能得到改善；临床症状改善程度与治疗前的免疫功能状态相关。The purpose of this study was to investigate the relationship between immune variables and psychopathology in patients with chronic schizophrenia before and after neuroleptic treatment, to evaluate the effect of neuroleptic on the immune parameters and the correlation between changes of immune variables and therapeutic effectiveness. T cell subsets (expressing with numbers of CD + 3, CD + 4,CD + 8 and CD 4/CD 8), and mitogen stimulated interleukin 2 (IL 2) secretary cells were measured and the clinical symptoms were assessed with Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) in 50 chronic schizophrenic patients before and after a 12 week stable dosage haloperidol treatment (0.25 mg· kg -1 · d -1 ). The results showed that the basal CD + 3, CD + 4, CD 4/CD 8 and IL 2 secretary cells were significantly decreased compared with normal controls. The number of CD + 4 enhanced significantly after treatment. There was a significantly negative correlation between SAPS score and CD 4/CD 8 before treatment, but no such correlation was found at the end of treatment course. The rates of reduced score of BPRS, SAPS, SANS were significantly correlated with the numbers of basal CD + 3 T cells respectively. The rate of reduced score of SANS was significantly correlated with basal CD + 4 too. Our results suggest that the remission of immune dysfunction is concomitant with the improvements of psychopathological symptoms in schizophrenic patients treated with antipsychotic drug, and the degree of symptom improvement is related to the conditions of immune function before treatment.

关 键 词：精神分裂症 免疫指标 精神症状 

分 类 号：R749.3[医药卫生—神经病学与精神病学]