长期住院男性精神分裂症患者血清神经营养因子水平与认知功能相关研究

发布时间：2018-06-20 00:47

本文选题：精神分裂症 + 脑源性神经营养因子(BDNF)　；参考：《扬州大学》2017年硕士论文

【摘要】：目的:精神分裂症是一种严重的精神疾病,有证据显示神经营养因子异常可能导致中枢及外周神经系统神经发育、神经连接及神经可塑性的异常。目前研究认为神经营养因子可能与精神分裂症患者的病理生理机制和认知功能有关。脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)和胶质源性神经营养因子(glial cell line-derived neurotrophic factor,GDNF)在精神疾病的研究领域得到了越来越多的重视。同时随着神经电生理技术的进步,事件相关电位尤其是事件相关电位P300被广泛应用于认知功能领域的研究。因此本研究利用认知量表及事件相关电位P300作为研究认知功能工具,探索长期住院的男性精神分裂症患者血清神经营养因子(BDNF、GDNF)水平的变化、认知功能的状况以及血清BDNF、GDNF水平与认知功能及事件相关电位P300之间的相关性。方法:2015年8月至2016年7月入组82例在江苏省扬州五台山医院长期住院的男性精神分裂症患者和52例正常对照组。采用言语流畅性测试(动作命名测试、动物命名测试)、数字划消测试、连线测试(Trail Making Test,TMT,包括 TMT-A、TMT-B)、Stroop 测试(单词、颜色、色词干扰测试)、木块图测试、WMS-Ⅲ空间广度测试(WechslerMemory Scale-Ⅲ Spatial Span Test,WMS-Ⅲ SST)评估患者与正常组的认知功能。采用美国Nicolet Viking Quste诱发电位仪记录事件相关电位P300的潜伏期和波幅。同时通过酶联免疫吸附法(Enzyme Linked Immunosorbent Assay,ELISA)检测所有被试者的血清 BDNF、GDNF浓度。结果:1.患者组与对照组血清BDNF水平分别为(9.1±2.1)ng/ml和(11.6±2.3)ng/ml,两组间血清BDNF水平存在统计学差异(t=-6.186,P0.01);患者组与对照组血清GDNF水平分别为(603.4±182.6)pg/ml和(610.22±176.3)pg/ml,两组间血清GDNF水平无统计学差异(t=0.201,P0.05)。2.患者组在言语流畅性功能(动作命名测试、动物命名测试)、注意功能(数字划消测试、TMT-A、单词测试、颜色测试)、执行功能(色词干扰测试、TMT-B)以及空间功能(木块图测试、WMS-Ⅲ SST)都显著差于对照组,且都具有统计学意义(P0.01)。患者组认知量表与年龄、受教育年限、病程和PANSS评分之间具有一定的相关性。患者组事件相关电位P300潜伏期较正常组明显延长(t=22.990,P0.01),波幅较正常组明显降低(t=-9.699,P0.01)。3.在患者组,事件相关电位P300潜伏期与数字划消测试及TMT-A呈正相关(r=0.481,P0.01;r=0.245,P0.05),事件相关电位P300波幅与数字划消测试呈负相关(r=-0.338,P0.01)。在患者组,血清BDNF水平与数字划消测试、TMT-B呈负相关(r=-0.281,P0.05;r=-0.355,P0.05)。患者组的血清GDNF水平与木块图测试呈正相关(r=0.272,P0.05)。4.患者组血清BDNF水平与事件相关电位P300的潜伏期呈负相关与波幅呈正相关(r=-0.262,P0.05;r=0.365,P0.01)。血清GDNF水平与事件相关电位P300的潜伏期及波幅没有相关性。结论:1.处于疾病相对稳定期的精神分裂症患者仍存在认知功能的损害。2.血清BDNF水平可能是精神分裂症患者的一种素质性的生物标志。3.血清BDNF、GDNF水平可能与精神分裂症患者认知功能之间存在一定的相关性。4.血清BDNF水平可能与精神分裂症患者事件相关电位P300之间存在一定的相关性。
[Abstract]:Objective: schizophrenia is a serious mental illness. There is evidence that abnormal neurotrophic factors may lead to neurodevelopment, nerve connections and abnormal plasticity in the central and peripheral nervous system. Neurotrophic factors may be associated with the pathophysiological mechanism and cognitive function of schizophrenic patients. The brain-derived neurotrophic factor (BDNF) and glial derived neurotrophic factors (glial cell line-derived neurotrophic factor, GDNF) have been paid more and more attention in the field of mental illness. Meanwhile, with the progress of neurophysiological technology, the event related potential, especially the event related potential P300 This study uses the cognitive scale and the event related potential P300 as a cognitive function tool to explore the changes in serum neurotrophic factor (BDNF, GDNF) levels, the status of cognitive function and the level of serum BDNF, GDNF and cognitive function in the long hospitalized male schizophrenic patients. And the correlation between the event related potential P300. Methods: from August 2015 to 7 2016, 82 cases of male schizophrenic patients and 52 normal controls were enrolled in the Yangzhou Wu Tai Mountain Hospital of Jiangsu province for a long time. The speech fluency test (action naming test, animal naming test), digital elimination test, and connection test (Trail Making T) were used. EST, TMT, including TMT-A, TMT-B), Stroop test (word, color, color word interference test), block diagram test, WMS- III space span test (WechslerMemory Scale- III Spatial Span Test, WMS- III) evaluate the cognitive function of patients and normal groups. The serum BDNF and GDNF concentrations of all the subjects were detected by Enzyme Linked Immunosorbent Assay (ELISA). Results: the serum BDNF levels of the 1. patients and the control group were (9.1 + 2.1) ng/ml and (11.6 + 2.3) ng/ml respectively, and there were statistical differences in the BDNF level between the two groups. The level of serum GDNF in the control group was (603.4 + 182.6) pg/ml and (610.22 + 176.3) pg/ml, and there was no statistical difference between the two groups (t=0.201, P0.05) in.2. patients in the speech fluency function (the action naming test, animal naming test), the attention function (Digital elimination test, TMT-A, word test, color test), and the executive function (color word stem). The interference test, TMT-B) and the spatial function (block diagram test, WMS- III SST) were all significantly worse than the control group, and all had statistical significance (P0.01). The patient group cognitive scale had a certain correlation with age, the years of education, the course of disease and the PANSS score. The latency of the event related potential P300 in the patient group was significantly longer than that of the normal group (t=22.990, P0.0). 1), the amplitude of wave amplitude was significantly lower than that of the normal group (t=-9.699, P0.01).3. in the patient group, the latency of the event related potential P300 was positively correlated with the digital cancellation test and TMT-A (r=0.481, P0.01; r=0.245, P0.05), and the event related potential P300 amplitude was negatively correlated with the digital cancellation test (r=-0.338, P0.01). -B was negatively correlated (r=-0.281, P0.05; r=-0.355, P0.05). The serum GDNF level of the patient group was positively correlated with the test of block diagram (r=0.272, P0.05). The serum BDNF level and the incubation period of the event related potential P300 were positively correlated with the amplitude of the amplitude. There is no correlation between phase and amplitude. Conclusion: 1. the schizophrenia patients in the relatively stable period of the disease still have cognitive impairment, the level of.2. serum BDNF may be a quality-oriented biomarker of.3. serum BDNF in schizophrenic patients, and the level of GDNF may have a certain correlation with the cognitive function of the schizophrenic patients,.4. There may be a correlation between serum BDNF level and event-related potential P300 in schizophrenic patients.
【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.3

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