难治性强迫障碍患者认知功能和血浆C反应蛋白水平的关联  

Association of cognitive function,plasma C-reactive protein level in patients with treatment-resistant obsessive-compulsive disorder

作　　者：夏舜尧 魏贵明 石川[1] 岳伟华[1] 迟锐 XIA Shunyao;WEI Guiming;SHI Chuan;YUE Weihua;CHI Rui(Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking U-niversity),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Beijing 100083,China;Daizhuang Hospital of Shandong Province,Jining 272051,Shandong Province,China)

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083 [2]山东省戴庄医院,山东济宁272051

出　　处：《中国心理卫生杂志》2023年第12期1031-1037,共7页Chinese Mental Health Journal

基　　金：北京市脑计划(Z161100000216139);国家自然科学基金(81825009)。

摘　　要：目的:分析难治性强迫障碍(trOCD)患者的认知功能、临床症状与血浆C-反应蛋白(CRP)水平的关系。方法:纳入55例trOCD和45例非难治强迫障碍(non-trOCD)患者及65名正常对照。采用Yale-Brown强迫量表、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)、MATRICS共识认知成套测验(MCCB)等评估强迫、抑郁焦虑症状和认知功能,以免疫胶乳比浊法检测被试血浆CRP水平。结果:与其他组相比,trOCD组MCCB总分及信息处理速度、工作记忆、推理及问题解决能力较低,血浆CRP水平和高CRP患者比例(≥3 mg/L)较高(均P<0.05);non-trOCD不同CRP组间MCCB各维度差异无统计学意义(均P>0.05)。Logistic回归分析显示,难治性风险因素有强迫症状多(OR=2.01)、严重程度高(OR=2.29)、MCCB总分低(OR=4.01)、血浆CRP水平高(OR=4.24)、病程长(OR=3.23)(P<0.05)。结论:trOCD患者认知功能下降、血浆CRP水平升高,与强迫症状多、严重程度高和病程长关联。Objective:To evaluate the association of cognitive function,clinical symptoms,and plasma C-reac-tive protein(CRP)level in patients with treatment-resistant obsessive-compulsive disorder(trOCD).Methods:Fif-ty-five patients with trOCD,45 patients with non-trOCD,and 65 normal controls were enrolled.The Yale-Brown Obsessive-Compulsive Scale(YBOCS),Hamilton depression scale,Hamilton anxiety scale,MATRICS Consensus Cognitive Battery(MCCB)were used to evaluate the OCD,depressive or anxious clinical symptoms,as well as cognitive function,in above-mentioned subjects.The plasma CRP level were examined by using the latex-enhanced immunoturbidimetry methods in three groups.Results:Compared with the other two groups,the MCCB cognition scores,especially information processing speed,working memory,inferential knowledge and problem-solving skills were higher in the trOCD group,respectively(Ps<0.05).The plasma CRP level and percentage of cases with high CRP level(≥3 mg/L)in the trCOD group were higher than those in other two groups(P<0.05).However,difference of MCCB and its factorial scores revealed no statistical significances in non-trOCD group(Ps>0.05).Logistic regression analysis showed that potential risk factors of treatment-resistant OCD including,more obsessive-compulsive symptoms(OR=2.01),higher severity of OCD(OR=2.29),lower MCCB total scores(OR=4.01),higher plasma CRP level(OR=4.24),and longer disease course of OCD(OR=3.23)(P<0.05).Conclusion:Impaired cognitive function,high plasma C-reactive protein level,may be associated with more obsessive-compul-sive symptoms,higher severity of OCD,as well as long disease course of OCD.

关 键 词：难治性强迫障碍 认知功能 C-反应蛋白 抑郁症状 焦虑症状 

分 类 号：R749.72[医药卫生—神经病学与精神病学] R749.41[医药卫生—临床医学]