【摘要】 目的在细胞因子水平探讨精神分裂症和抑郁症病理机制的异同。方法首发精神分裂症和首发抑郁症患者各30例,分别单一接受利培酮(6mg/d)、帕罗西汀(20mg/d)治疗6周,治疗前后用阳性和阴性症状量表(PANSS)评估精神分裂症患者,并用汉密尔顿抑郁量表(HAMD)评估抑郁症患者。用酶联免疫吸附(ELISA)法测定治疗前后患者组和30名正常对照的血浆白细胞介素-2(IL-2)、可溶性白细胞介素-2受体(sIL-2R)、白细胞介素-6(IL-6)、可溶性白细胞介素-6受体(sIL-6R)的浓度。结果治疗前,2个患者组的血浆IL-2、sIL-2R、IL-6、sIL-6R均高于正常对照组(P<0.05);精神分裂症组血浆sIL-2R高于抑郁症组(P<0.05),而IL-2、IL-6、sIL-6R低于抑郁症组(P<0.05)。②治疗后,精神分裂症组血浆IL-2、sIL-6R较治疗前下降(P<0.05),抑郁症组血浆IL-2、sIL-2R、IL-6、sIL-6R均较治疗前下降(P<0.05);精神分裂症组血浆sIL-2R高于抑郁症组(P<0.05),而IL-2、sIL-6R低于抑郁症组(P均小于0.05)。③精神分裂症组治疗前后血浆IL-2变化率与PANSS总分减分率正相关(r=0.64,P<0.001);抑郁症组治疗前后血浆IL-2和IL-6的变化率均与HAMD总分减分率正相关(r=0.42,P=0.02;r=0.54,P=0.002)。结论精神分裂症和抑郁症细胞因子均存在异常,提示二者可能存在共同的病理机制,但细胞因子表达的差异可能与二者存在不同的生物学基础有关。更多还原

【Abstract】 Objective To explore the pathogenesis of schizophrenia and depressive disorder at cellular level.Methods Thirty first-episode schizophrenic patients and 30 first-episode depressive patients were recruited and treated with either risperdone(6 mg/d)or paroxetine hydrochloride(20mg/d),respectively for 6 weeks.Thirty healthy people served as normal controls.The Positive and Negative Syndrome Scale(PANSS)was utilized to evaluate the schizophrenic patients before and after treatment;Hamilton Depression Scale(HAMD)was used for evaluation of depressive patients before and after treatment.Enzyme-labeled immunosorbent assay(ELISA)was also used to measure the concentrations of IL-2、sIL-2R、IL-6、sIL-6R in blood plasma.Results ① Prior to treatment,the concentrations of the IL-2、sIL-2R、IL-6、sIL-6 from schizophrenia and depressive disorder groups were all higher than those from normal control group(P<0.05);the concentration of the sIL-2R from schizophrenia group was higher than that from depressive disorder group(P<0.05),whereas the concentrations of the IL-2、IL-6、sIL-6R from schizophrenia group were lower than those from depressive disorder group(P<0.05).② After treatment,the concentrations of the IL-2、sIL-6R from schizophrenia group and the concentrations of the IL-2、IL-6、sIL-2R and sIL-6R from depressive disorder group decreased(P<0.05).The concentration of sIL-2R from schizophrenia group was higher than that from depressive disorder group(P<0.05);the concentrations of the IL-2、sIL-6R from schizophrenia group were lower than those from depressive disorder group(P<0.05).③ In schizophrenia group,the IL-2 variation rates after treatment was positively associated with the decrease rate of PANSS total score(r=0.64,P<0.001).In depressive disorder group,the variation rates of IL-2 and IL-6 after trentment were positively associated with the decrease rates of HAMD total scores(r=0.42,P=0.02;r=0.54,P=0.002).Conclusions Cytokine abnormalities are present in both schizophrenia and depressive disorder,which suggest a common underlying pathogenesis of both schizophrenia and depressive disorder.The difference in expression patterns of cytokines suggests that schizophrenia and depressive disorder may have different neural substrates.更多还原