抗精神病药物治疗对精神分裂症患者外周血非酶类抗氧化物水平的影响  

Effect of antipsychotics on peripheral non-enzymatic antioxidants in patients with schizophrenia

作　　者：卢喆 王应谈 寻广磊[3] LU Zhe;WANG Yingtan;XUN Guanglei(Cheeloo College of Medicine,Shandong University,Jinan 250012,China)

机构地区：[1]山东大学临床医学院,山东济南250012 [2]济宁医学院精神卫生学院 [3]山东省精神卫生中心

出　　处：《精神医学杂志》2019年第4期260-264,共5页Journal of Psychiatry

摘　　要：目的探讨抗精神病药物对精神分裂症患者非酶类抗氧化物水平的影响。方法对107例急性期精神分裂症患者进行12周真实治疗状态下的观察,比较基线及治疗后第12周末外周血非酶类抗氧化物(尿酸、白蛋白和总胆红素)水平差异。根据入组时是否已经使用抗精神病药物将107例患者分为已经用药组(A组)及未曾用药组(B组),进行外周血非酶类抗氧化物水平的组间及组内比较。结果基线时,B组患者的尿酸水平低于A组(P=0.003),总胆红素水平高于A组(P=0.024),A组和B组之间白蛋白水平差异无统计学意义(P=0.289)。共有77例患者完成本研究。治疗后患者ALB和TBIL水平均较治疗前下降(P<0.01)。其中在A组观察到了相似的结果。按性别分层分析,A组男性患者治疗前后总胆红素水平差异无统计学意义(P>0.05)。B组患者UA水平较治疗前升高(P<0.05),而ALB及TBIL水平均较治疗前降低(P<0.01)。按性别分层分析,B组女性患者ALB与TBIL水平较治疗前降低(P<0.01)。治疗后两组PANSS总分均较治疗前降低(P<0.05)。治疗后第12周末,A组与B组间非酶类抗氧化物水平差异无统计学意义(P>0.05)。结论抗精神病药物可能具有一定的抗氧化作用,其中精神分裂症患者尿酸水平的升高可能和使用抗精神病药物有关,女性可能更容易受到氧化应激的影响。Objective To explore the effects of antipsychotics on non-enzymatic antioxidants in patients with schizophrenia.Methods A 12-week real world observation was carried out on 107 patients with schizophrenia at acute stage.Levels of peripheral non-enzymatic antioxidants(uric acid,albumin and total bilirubin)were compared at baseline and the end of the 12 th week after treatment.107 patients were divided into drug-use group(group A)and drug-na ve/free group(group B)based on whether accepting antipsychotics before enrollment.Results At baseline,level of uric acid in group B(P=0.003)was lower than that in group A.Level of total bilirubin in group B was higher than that in group A(P=0.024).There was no significant difference in albumin levels between group A and group B(P=0.289).A total of 77 patients completed the study.Levels of albumin and total bilirubin decreased significantly compared with those before treatment(P<0.01).Similar results were detected in group A.When the data was stratified by gender,there was no significant difference in levels of total bilirubin in male patients of group A before and after treatment(P>0.05).In group B,uric acid level increased significantly compared with those before treatment(P<0.05),while levels of albumin and total bilirubin decreased compared with those before treatment(P<0.01).When the data was stratified by gender,levels of albumin and total bilirubin in females of group B decreased significantly compared with those before treatment(P<0.01).After treatment,the total scores of PANSS in both groups decreased significantly compared with those before treatment(P<0.05).At the end of the 12 th week after treatment,there were no significant differences in non-enzymatic antioxidants levels between group A and group B(P>0.05).Conclusion Antipsychotics may have an antioxidant effect.The increase of UA level in schizophrenic patients may be related to the use of antipsychotics,and females may be more susceptible to oxidative stress.

关 键 词：抗精神病药物 精神分裂症 尿酸 白蛋白 总胆红素 

分 类 号：R749.3[医药卫生—神经病学与精神病学]