氯氮平、利培酮对首发精神分裂症偏执型患者血清细胞因子的影响  

Effect of Clozapine and Risperide on serum cytokine in first episode paranoid schizophrenia patient

作　　者：郭素芹[1] 陈娓[1] 吕路线[1] 张顺利[2] 成军[1] 李强[1] 

机构地区：[1]新乡医学院第二附属医院,新乡453002 [2]河南师范大学生命科学学院

出　　处：《中国免疫学杂志》2004年第2期117-120,共4页Chinese Journal of Immunology

基　　金：河南省自然科学基金资助(批准号012303044)

摘　　要：目的 :了解氯氮平、利培酮对首发精神分裂症偏执型患者血清α 肿瘤坏死因子 (TNFα)和白细胞介素 18(IL 18)的影响 ,并探讨TNFα、IL 18与精神病理的关系。方法 :对 5 8例首发精神分裂症偏执型患者给予氯氮平或利培酮治疗 ,分别在治疗前和治疗后第 4周末、8周末、6月末用酶联免疫吸附法检测血清TNFα和IL 18水平 ,并用阳性和阴性症状量表 (PANSS)及其因子分评估精神症状及其变化。结果 :精神分裂症患者治疗前TNFα和IL 18含量均显著高于对照组 (P <0 0 1) ,治疗后 4周末IL 18基本恢复正常水平 ,8周末TNFα基本恢复正常水平。利培酮组患者治疗后 8周末TNFα水平、6月末TNFα和IL 18水平均较治疗前显著下降 (P <0 0 5 )。氯氮平组患者治疗后 6月末IL 18水平较治疗前显著下降 (P <0 0 5 )。两种药物对TNFα、IL 18的影响比较无显著性差异 (P >0 0 5 )。治疗前TNFα水平与PANSS总分呈正相关 (P <0 0 5 ) ,TNFα与IL 18呈正相关 (P <0 0 5 )。治疗后 6月末TNFα减分率与PANSS总分减分率呈正相关 (P <0 0 5 ) ,两组患者抗精神病药物用量与TNFα、IL 18减分率均无相关关系 (P >0 0 5 )。结论 :氯氮平和利培酮对精神分裂症患者TNFα和IL 18均有抑制作用 。Objective:To study the effects caused by Clozapine and Risperide on tumor necrosis factor(TNFα) and interleukin-18(IL-18) in serum of the patient who sufer from paranoid schizophrenia first time,and to explore the relationship among TNFα,IL-18 and psychopathology.Methods:58 patients who first-episode paranoid schizophrenia were treated with Clozapine or Risperide. The level of TNFα and IL-18 in serum was measured with enzyme linked immunosorbent assay(ELISA) method before and after being treated with Clozapine and Risperide for 4 weeks、8 weeks and 6 months. The positive and negative syndrome scale (PANSS) score were used to evaluated the psychotic syndrome and their changes.Results:The levels of TNFα and IL-18 in serum of the patient before the treatment were higher significantly than that in the controls(P<0.01). The levels of IL-18 at the end of 4 weeks' treatment come back to normal levels. The levels of TNFα at the end of 8 weeks' treatment come back to normal levels. The levels of IL-18 in serum at the end of 6 months' treatment was lower significantly than that in pretreatment(P<0.05).In group treated with Risperide,the levels of TNFα in serum after 8 weeks' treatment,the levels of TNFα and IL-18 in serum after 6 months' treatment was decreased in comparison to pretreatment(P<0.05). In group treated with Clozapine, the levels of IL-18 in serum after 6 months' treatment was decreased in comparison to pretreatment(P<0.05). In pretreatment, TNFα level was positively correlated with the total of PANSS(P<0.05) and with IL-18(P<0.05).6 month treatment; the variance of TNFα was positively correlated with the variance of the total score of PANSS(P<0.05).In both groups, there was no correlation between the dose of antipsychotic agent and the variance of TNFα and IL-18(P>0.05).Conclusion:Both Clozapine and Risperide have similar immunosuppression actions on TNFα and IL-18 levels in schizophrenic patients. It is possible that the serum level of TNFα is related with the severity and syndrome variance of s

关 键 词：肿瘤坏死因子 白细胞介素-18 精神分裂症 氯氮平 利培酮 

分 类 号：R749.3[医药卫生—神经病学与精神病学]