精神分裂症患者治疗前血清MCP-1水平预测利培酮疗效（英文）  

Pretreatment Serum MCP-1 Level Predicts Response to Risperidone in Schizophrenia

作　　者：林晔喆 彭延敏 朱翠珍 粟幼嵩 施源 林治光 陈京红 崔东红 Yezhe LIN;Yanmin PENG;Cuizhen ZHU;Yousong SU;Yuan SHI;Zhiguang LIN;Jinghong CHEN;Donghong CUI

机构地区：[1]Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China [2]Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China [3]Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China

出　　处：《上海精神医学》2017年第5期287-294,共8页Shanghai Archives of Psychiatry

基　　金：The National Key Research and Development Program(2017YFC0909200);National Natural Science Foundation of China(NSFC,81171266,81271481,81571326,81500976);Ministry of Science and Technology Precision Medicine Project;Shanghai Key Laboratory of Psychotic Disorders(13dz2260500);Shanghai Municipal Planning Commission of Science and Research Fund(20154Y0194)

摘　　要：背景:精神分裂症是一种慢性致残性疾病,其发病及治疗可能与炎性细胞因子有关。目前细胞因子预测抗精神病药物疗效的研究尚少。目的:研究细胞因子对抗精神病药物疗效的预测作用。方法:采用横断面与自然观察随访相结合的方法,(1)对比精神分裂症患者组(n=64)基线期和正常对照组(n=53)血清IL-1β、TNF-α和MCP-1水平;(2)探索基线期细胞因子水平对奥氮平或利培酮单药治疗效果的影响。结果:(1)精神分裂症患者治疗前血清MCP-1水平明显高于健康对照组(t=2.62,p=0.010),IL-1β(t=1.43,p=0.154)、TNF-α(t=0.79,p=0.434)未见变化;(2)精神分裂症患者治疗前MCP-1水平与利培酮单药治疗4周后PANSS量表一般病理评分的减少量呈显著负相关(r=-0.658;p﹤0.001),但在奥氮平组中则未发现(r=-0.031;p=0.855);(3)纳入性别、年龄、受教育年限和BMI后等影响因素后,多元线性回归分析发现,基线血清MCP-1水平可作为利培酮单药治疗效果的独立预测因子(校正R2=0.409,β=-0.658,p﹤0.001)。结论:MCP-1可能参与精神分裂症的发生,治疗前血清MCP-1水平可能是利培酮疗效预测的生物标记物。Background:Schizophrenia is a chronic debilitating disease.The pathogenesis and treatment may be associated with inflammatory cytokines.There are few studies focusing on the prediction of cytokines in response to antipsychotics.Aim:To investigate whether cytokines would predict response to antipsychotics.Methods:Cross-sectional and natural observational cohort studies were applied to:(1)compare the baseline levels of serum IL-1β,TNF-αand MCP-1between schizophrenia(n=64)and healthy controls(n=53);(2)To investigate the impact of baseline cytokines to psychopathology following olanzapine and risperidone monotherapy.Results:(1)Baseline MCP-1level of patients with schizophrenia was significantly higher than healthy controls(t=2.62,p=0.010),while no significance was found in IL-1β(t=1.43,p=0.154)and TNF-α(t=0.79,p=0.434);(2)Pretreatment level of MCP-1significantly correlated with PANSS-G reduction following4weeks'of risperidone monotherapy(r=-0.658;p<0.001)but not olanzapine monotherapy(r=-0.031;p=0.855);(3)Further stepwise multiple linear regression analysis indicated that higher MCP-1level prior to treatment was a significant predictor of less PANSS-G reduction in schizophrenia patients following risperidone monotherapy(adjusted R2=0.409,β=-0.658,p<0.001),but not in the olanzapine group.Conclusion:MCP-1may play a role in the pathogenesis of schizophrenia.Pretreatment level of MCP-1may serve as a biomarker indicating response to risperidone treatment.

关 键 词：精神分裂症 MCP-1 利培酮 疗效预测 

分 类 号：R749.3[医药卫生—神经病学与精神病学]