非稳态负荷与首次发病精神分裂症患者临床症状的关系及对发病的影响  

Correlation between allostatic load and clinical characteristics of first-episode schizophrenia and its influence upon the onset

作　　者：周衍芳 张苹 勾梦壮 仝景慧 黄隽超 谢婷 于婷[3] 谭淑平[4] 王志仁[1] 田宝朋 杨甫德[3] 谭云龙[3] Zhou Yanfang;Zhang Ping;Gou Mengzhuang;Tong Jinghui;Huang Junchao;Xie Ting;Yu Ting;Tan Shuping;Wang Zhiren;Tian Baopeng;Yang Fude;Tan Yunlong(Department of Science and Technology,Peking University HuiLongGuan Clinical Medical School,Beijing HuiLongGuan Hospital,Beijing 100096,China;Department of Education,Peking University HuiLongGuan Clinical Medical School,Beijing HuiLongGuan Hospital,Beijing 100096,China;Department of Psychiatry,Peking University HuiLongGuan Clinical Medical School,Beijing HuiLongGuan Hospital,Beijing 100096,China;Research Center of Psychiatry,Peking University HuiLongGuan Clinical Medical School,Beijing HuiLongGuan Hospital,Beijing 100096,China)

机构地区：[1]北京大学回龙观临床医学院科技处,北京回龙观医院,100096 [2]北京大学回龙观临床医学院教育处,北京回龙观医院,100096 [3]北京大学回龙观临床医学院精神科,北京回龙观医院,100096 [4]北京大学回龙观临床医学院精神医学研究中心,北京回龙观医院,100096

出　　处：《中华精神科杂志》2021年第3期184-189,共6页Chinese Journal of Psychiatry

基　　金：北京大学医学部优秀博士研究生创新基金(71006Y2464)。

摘　　要：目的探索非稳态负荷(allostatic load,AL)与首次发病精神分裂症患者临床症状的相关性及对疾病发生的影响。方法以2017年10月至2019年7月就诊于北京回龙观医院的首次发病精神分裂症患者(精神分裂症组,n=93)及同期招募的健康对照者(对照组,n=111)为研究对象,收集所有被试者的收缩压、舒张压、静息心率、体重指数、腰臀比、高密度脂蛋白胆固醇浓度、总胆固醇浓度、糖化血红蛋白、超敏C反应蛋白浓度、12 h尿肾上腺素浓度、12 h尿去甲肾上腺素浓度、12 h尿皮质醇浓度、血清脱氢表雄酮浓度以计算AL指数;采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评估患者的精神病理症状。采用协方差分析比较2组AL指数及13个生物学指标的差异,采用Pearson相关分析探索AL指数与临床症状的相关性,采用Logistic回归分析探讨精神分裂症发病的危险因素。结果精神分裂症组AL指数显著高于对照组(5.87±1.90比3.50±2.21,F=65.97,P<0.001);AL指数与PANSS阳性症状分呈显著正相关(r=0.25,P=0.019);Logistic回归结果显示,AL指数升高是精神分裂症发病的危险因素(OR=1.76,95%可信区间:1.47~2.11,P<0.01)。结论AL与首次发病精神分裂症患者阳性症状相关,AL升高可能是疾病的重要诱发因素之一。Objective To explore the possible correlation between allostatic load(AL)and clinical symptoms in patients with first-episode schizophrenia(FES)and AL influence upon the onset.Methods Patients with FES(schizophrenia group,n=93)who received treatment at Beijing Huilongguan Hospital from October 2017 to July 2019 and the healthy controls(control group,n=111)recruited during the same period were enrolled in the research.Systolic blood pressure,diastolic blood pressure,resting heart rate,body mass index,waist-hip ratio,high-density lipoprotein cholesterol,total cholesterol,glycosylated hemoglobin,high-sensitivity C-reactive protein,12-hour urine adrenaline,12-hour urine norepinephrine,12-hour urine cortisol,and serum dehydroepiandrosterone of all subjects were collected to calculate the AL index.The positive and negative symptom scale(PANSS)was used to assess the psychopathological symptoms of patients.Covariance analysis was used to compare the differences of AL index and the thirteen biological components between FES patients and controls.Pearson correlation analysis was used to explore the correlation between AL index and clinical symptoms,and the Logistic regression analysis was used to explore the risk factors of schizophrenia.Results AL index among schizophrenic patients was higher than the controls(5.87±1.90 vs.3.50±2.21,F=65.97,P<0.001).AL index was possitively correlated with PANSS positive symptoms(r=0.25,P=0.019)and was a risk factor of schizophrenia(OR=1.76,95%CI:1.47-2.11,P<0.01).Conclusions The AL is possitively correlated with positive symptoms in the FES,and the higher AL may be one of important inducements to the schizophrenia onset.

关 键 词：应激 精神分裂症 非稳态负荷 

分 类 号：R749.3[医药卫生—神经病学与精神病学]