血清GDNF、DHEA-S、Hcy水平评估首发精神分裂症精神症状程度的价值  

The Value of Serum GDNF,DHEA-S and Hcy Levels in Evaluating the Degree of Psychiatric Symptoms in First-Episode Schizophrenia

作　　者：马瑞晨[1] 韩甜甜 马燕娟[1] MA Ruichen;HAN Tiantian;MA Yanjuan(Department of Psychiatry,the Fourth People's Hospital of Urumqi,Urumqi,Xinjiang 830002,China)

机构地区：[1]乌鲁木齐市第四人民医院精神科,新疆乌鲁木齐830002

出　　处：《中国医药指南》2025年第1期6-9,共4页Guide of China Medicine

基　　金：乌鲁木齐市2016年乌鲁木齐市科学技术计划项目(Y161310016)。

摘　　要：目的探讨血清胶质细胞源性神经营养因子(GDNF)、硫酸脱氢表雄酮(DHEA-S)、同型半胱氨酸(Hcy)水平与首发精神分裂症精神症状程度的关系,并分析其评估价值。方法选取本院2016年2月至2019年2月期间收治的首发精神分裂症患者60例作为观察组,同期60例健康体检者为对照组。对比不同精神症状程度的首发精神分裂症患者血清GDNF、DHEA-S、Hcy水平的差异性,分析血清GDNF、DHEA-S、Hcy水平对首发精神分裂症患者中、重度精神症状程度的诊断价值,并分析GDNF、DHEA-S、Hcy水平如何影响首发精神分裂症患者精神症状程度。结果60例首发精神分裂症患者中轻度精神症状18例,中度精神症状27例,重度精神症状15例;观察组阳性及阴性综合征量表评分、DHEA-S、Hcy水平均低于对照组(P<0.05),GDNF水平高于对照组(P<0.05);轻度组、中度组、重度组阳性及阴性综合征量表评分、DHEA-S、Hcy水平依次升高(P<0.05),GDNF水平依次降低(P<0.05);经过ROC分析,血清GDNF、DHEA-S、Hcy水平评估首发精神分裂症患者精神症状程度为中、重度的AUC分别为0.753、0.762、0.736,灵敏度分别为0.833、0.643、0.595,均P<0.05;Logistic多因素回归分析结果显示,GDNF≤454.545 ng/L、DHEA-S≥83.970 nmol/L、Hcy≥22.925μmol/L为首发精神分裂症患者精神症状严重程度的危险因素(OR=5.572、7.425、9.698,P值均<0.05)。结论血清GDNF、DHEA-S、Hcy水平可用于首发精神分裂症精神症状程度的评估,且GDNF水平越低、DHEA-S、Hcy水平越高,其精神症状的严重程度越重。Objective To investigate the relationship between serum levels of glial cell derived neurotrophic factor(GDNF),dehydroepiandrosterone sulfate(DHEA-S)and homocysteine(Hcy)and the degree of symptoms in first schizophrenia,and to analyze their evaluation value.Methods Sixty patients with first-episode schizophrenia admitted to our hospital from February 2016 to February 2019 were selected as the observation group,and 60 healthy subjects during the same period were selected as the control group.The difference of serum GDNF,DHEA-S and Hcy levels in first-episode schizophrenia patients with different degrees of psychiatric symptoms was compared to analyze the diagnostic value of serum GDNF,DHEA-S and Hcy levels in the degree of moderate and severe psychiatric symptoms in first-episode schizophrenia patients.The effects of GDNF,DHEA-S and Hcy levels on the degree of psychotic symptoms in patients with first-episode schizophrenia were analyzed.Results Among the 60 patients with first-episode schizophrenia,there were 18 cases of mild mental symptoms,27 cases of moderate mental symptoms and 15 cases of severe mental symptoms.The scores of positive and negative syndrome scale,DHEA-S and Hcy levels in the observation group were lower than those in the control group(P<0.05),and the GDNF level was higher than that in the control group(P<0.05).The scores of positive and negative syndrome scale,DHEA-S and Hcy levels in mild group,moderate group and severe group increased in turn(P<0.05),while GDNF levels decreased in turn(P<0.05).After ROC analysis,the AUC of serum GDNF,DHEA-S and Hcy levels in evaluating the degree of moderate and severe mental symptoms in patients with first-episode schizophrenia were 0.753,0.762 and 0.736,respectively,and the sensitivity was 0.833,0.643 and 0.595,respectively,P<0.05.Logistic multivariate regression analysis showed that GDNF≤454.545 ng/L,DHEA-S≥83.970 nmol/L and Hcy≥22.925μmol/L were risk factors for the severity of psychiatric symptoms in patients with first-episode schizophrenia(OR=5.

关 键 词：首发精神分裂症 精神症状程度 胶质细胞源性神经营养因子 硫酸脱氢表雄酮 同型半胱氨酸 

分 类 号：R749.3[医药卫生—神经病学与精神病学]