【摘要】 目的了解精神分裂症患者在抗精神病药物治疗过程中的细胞因子及体液免疫的变化,以及免疫因子与精神症状、治疗敏感度的关系。方法把符合ICD-10关于精神分裂症诊断标准的精神分裂症患者43例分为氯丙嗪组(23例)、氯氮平组(20例),并以健康对照组比较,对患者组在治疗始、治疗第8周末及健康组用酶联免疫吸附法(ELISA)测定血清IL-12、TNF-α水平,用透射比浊法测定IgA、IgM、IgG、C3、C4水平,患者组用阳性和阴性症状量表(PANSS)进行精神症状评定。结果患者组C3、C4血清水平显著低于健康组(t=7.499,p=0.000;t=5.309,p=0.000),两组IL-12血清浓度治疗后第8周末比治疗前明显增高(t=2.444,p=0.023;t=2.975,p=0.008),氯氮平组的IgG在治疗后第8周末明显增高(t=2.289,p=0.035)。IL-12与住院次数、性别呈正相关(r=0.309,p=0.009;r=0.335,p=0.027);TNF-α与家族史呈正相关(r=0.396,p=0.009);IgA、C3、C4与婚姻呈正相关(r=0.355,p=0.019;r=0.312,p=0.041;r=0.335,p=0.028);IgG与阴性症状分呈正相关(r=0.323,p=0.034);IgG变化率与药物呈正相关(r=0.354,p=0.023);IgA变化率与8周末一般精神病理分呈负相关(r=-0.402,p=0.009)。结论精神分裂症患者存在一定程度的免疫功能紊乱,具有自身免疫性特点,典型与非典型的抗精神药物对患更多还原

【Abstract】 Objective: To study the effects caused by antipsychotic drugs on serum level of cytokine and humoral immunity in patients with schizophrenia,and to explore the relationship among immune factors、psychiatric symptoms and the sensitivity of therapy. Methods: Forty-three patients with schizophrenia meeting ICD-10 were enrolled in the study.They were divided into two groups: chloropromazine group including 23 patients and clozapine gronp including 20 patients.The levels of IL-12、TNF-αin serum were measured with enzyme linked immunosorbent assay(ELISA) method. The levels of IgA、IgM、IgG、C3、C4 in serum were measured with turbidimetry method,and examined 24 normal control subjects.The positive and negative syndrome scale (pANSS) was used to evaluated the psychotic syndrome. Results:The levels of C3、C4 in serum of patients with schizophrenia were lower than those in normal control group(p<0.01). The levels of IL-12 in serum of two patients groups at the end of 8th weekend were higher than that of pretreatment (t=2.289,p=0.035). IL-12 was positively correlated with the frequency of hospitalization and gender, TNF-α was positively correlated with family history . IgA、C3、C4 were positively correlated with marriage . IgG was positively correlated with negative symptoms . The change of IgG was positively correlated with drugs . The change of IgA was negatively correlated with the score of general psychosis pathology at the end of 8th weekend. Conclusion:There were some immune functional deficits in patients with schizophrenia.,and they presented features of autoimmunity . Typical and atypical antipsychotic drugs may have different effects and actions of immunological regulation on patients with schizophrenia.更多还原