精神分裂症患者治疗前后的Tie-2、VEGF、PRL变化及其临床意义  

Changes of Tie-2,VEGF,and PRL in patients with schizophrenia before and after treatment and their clinical significance

作　　者：赵淑芝 赵福涛 孙艺茹 李聪慧 ZHAO Shu-zhi;ZHAO Fu-tao;SUN Yi-ru;LI Cong-hui(Department of General Psychiatry,Henan Rongkang Hospital,Luoyang 471000,Henan,CHINA;Sleep Medicine Center,Zhumadian Second People's Hospital,Zhumadian 463000,Henan,CHINA;Department of Clinical Laboratory,Precision Medicine Center of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]河南省荣康医院普通精神科,河南洛阳471000 [2]驻马店市第二人民医院睡眠医学中心,河南驻马店463000 [3]郑州大学精准医学中心检验科,河南郑州450000

出　　处：《海南医学》2024年第10期1440-1445,共6页Hainan Medical Journal

基　　金：2022年河南省医学科技攻关联合共建项目(编号:LHGJ20223936)。

摘　　要：目的探讨精神分裂症患者治疗前后血管生成素受体酪氨酸激酶2(Tie-2)、血管内皮生长因子(VEGF)、泌乳素(PRL)的变化及其临床意义。方法回顾性分析2021年7月至2023年9月河南省荣康医院收治的91例精神分裂症患者的临床资料,根据治疗应答情况分为有效组77例和无效组14例。比较两组患者治疗前、治疗2周和4周后的Tie-2、VEGF、PRL水平。应用皮尔逊(Pearson)相关性分析Tie-2、VEGF、PRL与帕利哌酮血药浓度的相关性及其与治疗应答的相关性,绘制受试者工作特征曲线(ROC)评价Tie-2、VEGF及两者联合预测精神分裂症患者治疗后疗效为有效的价值,采用精准-召回曲线评价ROC分析的准确度。结果91例精神分裂症患者治疗后临床痊愈19例,显效48例,好转10例,无效14例,有效率为84.62%;帕利哌酮血药浓度第1~2周呈明显升高趋势,第2周达峰值,第2~4周处于较稳定水平;有效组患者治疗2周和4周后的Tie-2分别为(2153.42±157.83)pg/mL、(2279.88±135.25)pg/mL,明显高于无效组的(1782.19±208.54)pg/mL、(1788.15±223.48)pg/mL,VEGF分别为(422.39±41.65)pg/mL、(461.37±52.80)pg/mL,明显高于无效组的(310.55±24.78)pg/mL、(312.67±27.99)pg/mL,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,PRL治疗2周和4周后的变化值与帕利哌酮血药浓度呈显著正相关(r=0.712、0.665,P<0.01);Tie-2和VEGF治疗2周和4周后的变化值与PANSS减分率呈显著正相关(r=0.769、0.752;0.778、0.758,P<0.01);经ROC分析结果显示,Tie-2联合VEGF预测治疗应答的ROC下面积(AUC)为0.899,大于Tie-2(0.769)、VEGF(0.707)(P<0.05);经精准-召回曲线分析结果显示,其AUC为0.901,意味着高精准率和高召回率,采用Tie-2联合VEGF预测治疗应答能为临床医生提供决策支持。结论精神分裂症患者治疗后Tie-2、VEGF变化与帕利哌酮治疗应答有关,联合检测两者可作为预测治疗应答一个方案,为临床医生提供决策支持,PRL变化�Objective To investigate the changes of angiopoietin receptor tyrosine kinase 2(Tie-2),vascular endothelial growth factor(VEGF),and prolactin(PRL)in patients with schizophrenia before and after treatment and their clinical significance.Methods The clinical data of 91 patients with schizophrenia admitted to Henan Rongkang Hospital from July 2021 to September 2023 were retrospectively analyzed.According to the treatment response,the pa-tients were divided into an effective group of 77 cases and an ineffective group of 14 cases.The levels of Tie-2,VEGF,and PRL were compared between the two groups before treatment,after 2 weeks of treatment,and after 4 weeks of treat-ment.Pearson correlation analysis was used to investigate the correlation between Tie-2,VEGF,PRL and plasma con-centration of paliperidone,as well as the correlation between Tie-2,VEGF,PRL and the treatment response.The receiv-er operating characteristic(ROC)curve was used to evaluate the value of Tie-2,VEGF,and their combination in predict-ing the efficacy of treatment in patients with schizophrenia.The accuracy of ROC analysis was evaluated using the preci-sion-recall curve.Results After treatment,19 of the 91 patients showed clinical recovery,48 showed significant im-provement,10 showed improvement,and 14 showed no improvement,with an effective rate of 84.62%.The plasma concentration of paliperidone showed a significant increase in the first two weeks,reaching a peak in the second week,and remained stable in the second to fourth week.The Tie-2 levels in the effective group after two and four weeks of treatment were(2153.42±157.83)pg/mL and(2279.88±135.25)pg/mL,respectively,which were significantly higher than(1782.19±208.54)pg/mL and(1788.15±223.48)pg/mL in the ineffective group;the VEGF levels were(422.39±41.65)pg/mL and(461.37±52.80)pg/mL,respectively,which were significantly higher than(310.55±24.78)pg/mL and(312.67±27.99)pg/mL in the ineffective group;the differences were statistically significant(P<0.05).Pearson correla-tion analysis show

关 键 词：精神分裂症 血管生成素受体酪氨酸激酶2 血管内皮生长因子 泌乳素 治疗应答 帕利哌酮 血药浓度 

分 类 号：R749.3[医药卫生—神经病学与精神病学]