【摘要】 目的:探讨女性精神分裂症患者血清白细胞介素6(IL-6)、可溶性白细胞介素6受体(sIL-6R)治疗前后变化及其与抗精神病药物氯氮平血清水平的关系。方法:采用酶联免疫吸附法测定40例女性精神分裂症患者(病程≥5年组和病程<5年组,每组20例)治疗前及治疗后第1、2和4周血清IL-6和sIL-6R水平,同时用高效液相色谱法测定氯氮平水平,以20例女性健康者血清IL-6、sIL-6R水平作对照。治疗前与治疗后第4周评定阴性和阳性症状量表(PANSS)各一次。结果:①病程≤5年组患者治疗前血清IL-6和sIL-6R水平均显著高于正常对照组(P<0.01);治疗后第1、2和4周血清IL-6和sIL-6R水平均显著低于对照组(P<0.01)。②病程>5年组患者治疗前及治疗后第1,2和4周血清IL-6、sIL-6R水平均显著低于正常对照组(P<0.01)。③除病程>5年组患者第1周血清IL-6水平与氯氮平水平呈负相关(r=0.57,P<0.01)外,余各时点血清sIL-6R水平与氯氮平水平均无显著相关性(r=-0.36～0.17,P>0.05)。④氯氮治疗4周后,PANSS减分率与IL-6,sIL-6R减分率无显著相关(r=-0.22～-0.01,P>0.05)。结论:女性精神分裂症患者血清IL-6、sIL-6R水平与健康女性差异显著,氯氮平对IL-6和SIL-6R有抑制作用,氯氮平的抗精神病作用可能与对IL-6,sIL-6R的调节作用有关。更多还原

【Abstract】 AIM:To investigate the changes of serum levels of interleukin 6(IL 6) and soluble interleukin 6 receptor(sIL 6R) in female schizophrenic patients before and after treatment,and their relationships with serum level of the antipsychotic drug,clozapine.METHODS:The serum levels of IL 6 and sIL 6R were tested by enzyme linked immunoadsordent assay(ELISA),and serum level of clozapine by high performance liquid chromatography(HPLC) in 40 female schizophrenic patients(duration of schizophrenia≥5 years group and < 5 years group with 20 cases each) before and on the first,second,fourth weeks after treated with clozapine. The serum levels of IL 6 and sIL 6R were also tested in 20 healthy controls.Patients with schizophrenia were assessed by positive and negative symptom scale(PANSS) before and on the fourth week after treated with clozapine.RESULTS:①The serum levels of IL 6 and sIL 6 were significantly higher in duration of schizophrenia≤5 years group than in the normal control group before treatment(P< 0.01),significantly lower in the former group than in the latter group on the first,second and fourth week after treatment(P< 0.01).②The serum levels of IL 6 and sIL 6 were all significantly lower in duration of schizophrenia >5 years group than in the normal control group before and on the first,second and fourth week after treatment(P< 0.01).③There was no significant correlation between the serum level of IL 6 and level of clozapine at other time points(r=-0.36 to 0.17,P >0.05),except negative correlation between them in the duration of schizophrenia≤5 years group on the first week after treatment(r=0.57,P< 0.01).④On the fourth week after treatment,no significant correlation was found between the decrease rate of PANSS and that of IL 6(r=-0.22 to -0.01,P >0.05).CONCLUSION:There is significant difference between female schizophrenic patients and normal controls in the serum levels of IL 6 and sIL 6R.Clozapine can inhibit the activity of IL 6 and sIL 6R,so there is probable correlation between the antipsychotic effects of clozapine and the immunoloregulation of IL 6 and sIL 6R.更多还原