男性缺陷型与非缺陷型精神分裂症患者血清胶质源性神经营养因子水平及其与认知功能的相关分析  

Serum levels of glial cell line-derived neurotrophic factor and its correlation with cognitive function in male patients with deficit and non-deficit schizophrenia

作　　者：段维维 杨韦[2] 唐小伟 DUAN Wei-wei;YANG Wei;TANG Xiao-wei(Department of Psychiatry,Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院精神卫生学院,272000 [2]济宁市精神病防治院精神科 [3]江苏省扬州五台山医院精神科,南京医科大学附属脑科医院

出　　处：《临床精神医学杂志》2019年第4期232-236,共5页Journal of Clinical Psychiatry

基　　金：江苏省卫生和计划生育委员会指导性科研课题(Z201522);江苏省研究生科研与实践创新计划(KYCX18_1497)

摘　　要：目的:探讨男性缺陷型精神分裂症(DS)与非DS患者血清胶质源性神经营养因子(GDNF))水平及其与认知功能的相关性。方法:91例精神分裂症患者根据DS诊断量表(SDS)评估结果分为DS组(43例)和非DS组(48例);采用阳性与阴性症状量表(PANSS)评估临床症状;采用数字划消测验、连线测验(TMT)、空间广度测验(SST)、定步调连续加法任务测验(PASAT)、Stroop测验、木块图评估认知功能;使用酶联免疫吸附法(ELISA)检测血清GDNF水平;并与39名健康志愿者(对照组)比较;分析血清GDNF水平与认知功能的相关性。结果:3组间血清GDNF水平差异无统计学意义;3组间所有认知功能测验成绩差异有统计学意义(P<0.05或P<0.01);DS组数字划消测验、SST(逆行分)、TMT、Stroop测验、木块图及PASAT成绩显著差于非DS组,两患者组明显差于对照组(P<0.05或P<0.01)。DS组血清GDNF水平与PANSS阳性症状分、数字划消测验的错误数、TMT-B呈负相关(P均<0.05),与Stroop单词测验分、颜色测验分和色词干扰测验分呈正相关(P均<0.05);非DS组及对照组血清GDNF水平与认知功能测验成绩无相关性。结论:精神分裂症患者存在广泛的神经认知功能受损,DS患者更甚;稳定期DS及非DS患者血清GDNF水平与正常对照者无明显差异。Objective: To explore the level of glial cell line-derived neurotrophic factor (GDNF) and its correlation with cognitive function in male patients with deficit schizophrenia(DS) and non-deficit schizophrenia(NDS). Method: Ninety-one patients with schizophrenia were divided into DS group (43 cases) and NDS group (48 cases) according to schedule for the deficit syndrome (SDS) evaluation.The clinical symptoms of patients were evaluated by positive and negative symptom scales (PANSS).Digital cancellation test,trail making test (TMT),spatial span tes (SST),paced auditory serial addition task (PASAT),Stroop test and block design were used to assess subjects' neurocognitive functions.Serum levels of GDNF were detected by enzyme linked immunoadsorption(ELISA).The results were compared with 39 healthy volunteers (control group).The correlation between serum GDNF level and cognitive function was analyzed. Results: There was no significant difference in serum GDNF level among the 3 groups.There were significant differences in all cognitive function tests among the 3 groups ( P <0.05 or P <0.01).The results of digital cancellation test (required time),SST (retrograde score),TMT,Stroop test,block design and PASAT in DS group were worse than those in the NDS group,also those results in DS and NDS groups were worse than those in the control group ( P <0.05 or P <0.01).In DS group,serum GDNF level was negatively correlated with positive symptom score of PANSS,number of errors in digit cancellation test and TMT-B (all P <0.05),and was positively correlated with points of Stroop's word test,color test and color word interference test(all P <0.05).There was no correlation between serum GDNF level and results of cognitive function test in NDS and control groups. Conclusion: Schizophrenic patients have extensive neurocognitive impairment,especially in DS patients.Serum GDNF levels in stable DS and NDS patients are not significantly different from those in normal controls.

关 键 词：缺陷型精神分裂症 胶质源性神经营养因子 神经认知功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]