【摘要】 目的:探讨精神分裂症患者血浆肽食欲素-A(Orexin-A)表达水平及其与奥氮平治疗后体重增加的相关性。方法:选取北京回龙观医院2017年8月至2019年1月收治的精神分裂症患者76例(观察组)及同期入院体检的健康志愿者40例(对照组),均取晨空腹静脉血,采用酶联免疫吸附测定(ELISA)试验检测血浆Orexin-A水平,比较观察组中不同认知功能障碍、不同症状患者的Orexin-A水平;同时,随机选择36例首发精神分裂症患者持续应用奥氮平(20 mg/d)治疗,于治疗前、治疗后10个月测定血浆Orexin-A水平及体重指数(Ibm)、血清甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、简明精神病评定量表(BPRS)总分,分析各指标相关性。结果:观察组未用药时血浆Orexin-A水平高于对照组(P<0.01);随精神分裂症患者认知功能障碍加重,其Orexin-A水平升高,且焦虑犹豫因子、缺乏活力因子、思维障碍因子得分重度患者中Orexin-A水平较轻度患者高(P<0.01);36例首发精神分裂症患者经奥氮平治疗后10个月Orexin-A水平低于治疗前,而Ibm、TG、LDL-C明显升高,HDL-C下降(P<0.01),BPRS总分降低(P<0.01);相关性分析表明,Orexin-A水平与Ibm、LDL-C呈负相关关系(r=-0.298、-0.263,P<0.05),Orexin-A水平与BPRS总分呈正相关关系(r=0.414,P<0.05)。结论:血浆Orexin-A在精神分裂症中呈高表达,血浆Orexin-A水平可推测患者认知功能障碍程度,Orexin-A降低可能是奥氮平治疗精神分裂症患者后体重增加的原因。更多还原

【Abstract】 Objective: To investigate the expression level of plasma peptide orexin-A in patients with schizophrenia and its correlation with weight gain after olanzapine treatment. Methods: A total of 76 patients with schizophrenia(observation group) treated in our hospital from Aug. 2017 to Jan. 2019 and 40 healthy volunteers(control group) from physical examination in the same period were selected. Fasting venous blood was taken in the morning, and the level of plasma Orexin-A was detected by enzyme linked immunosorbent assay(ELISA).The level of Orexin-A in patients with different cognitive impairment and symptoms in the observation group was compared. At the same time, 36 patients with first-episode schizophrenia were randomly treated with olanzapine(20 mg/d). Before and 10 months after treatment, plasma Orexin-A level and body mass index, serum triglyceride(TG), high density lipoprotein(HDL-C), low density lipoprotein(LDL-C) and total score of brief psychiatric rating scale(BPRS) were measured, and the correlation of each index was analyzed. Results: The level of plasma Orexin-A in the observation group was higher than that in the control group(P<0.01). With the aggravation of cognitive impairment in patients with schizophrenia, the level of Orexin-A increased, and the level of Orexin-A in severe patients with anxiety and hesitation factor, lack of activity factor and thinking disorder factor was higher than that in mild patients(P<0.01). Ten months after olanzapine treatment, the level of Orexin-A in 36 patients with first-episode schizophrenia was lower than that before treatment, while the body mass index, the levels of TG and LDL-C increased significantly, and HDL-C decreased(P<0.01). The total score of BPRS decreased(P<0.01). Correlation analysis showed that the level of Orexin-A was negatively correlated with body mass index and LDL-C(r=-0.298,-0.263, P<0.05), and the level of Orexin-A was positively correlated with the total score of BPRS(r=0.414, P<0.05). Conclusion: Plasma Orexin-A is highly expressed in schizophrenia, and the level of plasma Orexin-A can speculate the degree of cognitive impairment. The decrease of Orexin-A may be the reason for weight gain after olanzapine treatment.更多还原