血清蛋白因子水平对精神分裂症诊断价值的探索  

AN EXPLORATION ON THE ROLE OF EIGHT KINDS OF SERUM PROTEIN FACTOR LEVELS IN DIAGNOSING SCHIZOPHRENIA

作　　者：曾勇[1] 吴秋霞[1] 熊鹏[1] 余敏[2] 姜林伶 李国华[1] 

机构地区：[1]昆明医科大学第一附属医院精神科,云南昆明650031 [2]云南大学生命科学院,云南昆明650031

出　　处：《河北医科大学学报》2012年第12期1382-1385,共4页Journal of Hebei Medical University

基　　金：云南省社会发展科技计划项目(2011CA018);云南省应用基础研究计划项目(2011FB172)

摘　　要：目的研究血清中神经生长因子(nerve growth factor,NGF)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、白细胞介素6(interleukin 6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor alpha,TNF-α)、干扰素-γ(interferon gamma,IFN-γ)、钙结合蛋白(calcium binding protein,S100β)、髓鞘碱性蛋白(myelin basic protein,MBP)和神经胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)8种蛋白因子水平对精神分裂症的诊断价值。方法用酶联免疫吸附技术(enzyme linked immunosorbent assay,ELISA)测定106例精神分裂症患者、105例抑郁症患者和120例正常对照者血清8种蛋白因子的浓度。用受试者工作特征(receiver operating characteristic,ROC)曲线评估8个因子的诊断价值。结果精神分裂症患者组血清NGF浓度低于抑郁症组和正常对照组[(32.55±2.12)ng/L vs(38.90±10.47)ng/L、(40.54±6.71)ng/L],差异有统计学意义(P<0.01)。精神分裂者组血清NGF诊断截断值35.73ng/L对应最佳灵敏度为86.7%,特异度为92.5%(95%CI=0.68～0.95),抑郁症组血清NGF诊断截断值36.04ng/L对应最佳灵敏度为85.8%,特异度为49.5%(95%CI=0.50～0.66),ROC曲线下面积(areas under the ROC curve,AUC)分别为0.91、0.58。采用逐步判别分析(stepwise discriminant analysis,SDA)进行数据的重新归类,从中发现NGF、IL-6、S100β、MBP和GFAP 5个因子浓度对协助诊断精神分裂症的贡献率更大,联合用5个因子的诊断价值均高于任何单种蛋白因子的诊断价值。结论应用蛋白因子浓度水平诊断精神分裂症是可行的,并有望进一步对精神分裂症的客观实验室检查提供新思路。Objective To investigate the changes of serum nerve growth factor （ NGF）, brain - derived neurotrophic factor （ BDNF ）, interleukin 6 （ IL -6）tumor necrosis factor alpha （TNF -α）,interferon gamma（ IFN - r） , calcium binding protein （ fibrillary acidic protein （GFAP）level and evaluate their concentrations of eight kinds of serum protein factor in - 6 ）, tumor necrosis factor alpha （ TNF - α ）, S100β） ,myelin basic protein （MBP） and glial diagnostic value in schizophrenia. Methods The 106 patients with schizophrenia, 105 patients with depression and 120 normal controls were assessed by enzyme linked immunosorbent assay（ELISA）. The diagnostic value of eight factors were evaluated with receiver operating characteristic （ ROC ） curve. Results Serum NGF concentration in schizophrenic patients was lower than that in patients with depression and normal control group [ （ 32.55 ± 2.12 ） ng/L vs （ 38.90 ± 10.47 ） ng/L, （40.54 ± 6. 71 ） ng/L ], and thedifferences were statistically significant （P 〈 O. 01 ）. In schizophrenic patients group, a serum NGF diagnostic cutoff value of 35.73 ng / L was chosen to maximize sensitivity at 86.7% with a corresponding specificity of 92.5% （95 % CI = O. 68 -O. 95 ）. In depression group, a serum NGF diagnostic cutoff value of 36.04 ng/L was chosen to maximize sensitivity at 85.8% with a corresponding specificity of 49.5% （95% CI = 0.50 - 0.66 ）. The corresponding areas under tile curve （AUC） were 0. 91 and 0.58, respectively. Stepwise discriminant analysis （SDA） were used to reclassify the data and create the fitting discriminant scores. It was found that NGF, IL -6, SIO0 β, MBP and GFAP make a greater contribution in assisting the diagnosis of schizophrenia, and the diagnosis value of combination of five factors were higher than that in any protein factor. Conclusion It is feasible to assist the diagnosis of schizophrenia with the protein concentrations, and it is expected to further provide new thinkin

关 键 词：精神分裂症 蛋白 ROC曲线 诊断 

分 类 号：R749.3[医药卫生—神经病学与精神病学]