免疫及炎症反应在精神分裂症中的关联性研究

发布时间：2019-05-28 11:45

【摘要】：目的:探讨免疫及炎症反应与精神分裂症的关系。方法:①根据国际疾病和相关健康问题统计分类第十版(ICD-10)选取从2016年3月至2016年12月在延边脑科医院住院的诊断为精神分裂症的患者,共收集84例,其中男性43例、女性41例。另选52例年龄相当的体检健康者为健康对照组,其中男性24例、女性28例。②用阳性与阴性症状量表(PANSS)评定精神分裂症患者精神症状。③搜集患者年龄、性别、婚姻状况、身高及体重等一般资料,计算BMI值。④取清晨空腹血(禁食12小时),采用全自动生化分析仪检测同型半胱氨酸(HCY)、C反应蛋白(CRP);用全自动血细胞分析仪及配套试剂盒质控品分类检验白细胞(WBC)、红细胞(RBC)、血红蛋白(HGB)、血细胞比容(HCT)、血小板(PLT)、中性粒细胞百分比(NEU%)、淋巴细胞百分比(LYM%)、中性粒细胞(NEU)、淋巴细胞(LYM)等,并计算中性粒细胞-淋巴细胞比率(NLR);用酶联免疫吸附法(ELISA)测定白细胞介素-6(IL-6)浓度。⑤采用SPSS 20.0软件进行统计学分析。正态分布的计量资料以均数±标准差(x±SD)表示,进行独立样本的t检验,非正态分布的计量资料以中位数(四分位数间距)[M(P25,P75)]表示,进行Mann-WhitneyU检验;计数数据以百分率表示,进行χ2检验;IL-6与其相关因素的相关性采用Spearman相关分析,免疫和炎症因子对精神分裂症的影响采用多因素logistic回归分析,以P0.05为差异有统计学意义。结果:①精神分裂症组 NLR、HCY、IL-6 和 LYMPH%分别为 2.06±0.80、17.1(8.65,28.53)、61.42(21.42,111.96)、和 31.22±6.88,健康对照组分别为 1.71±0.57、11.20(8.03,15.98)、25.61(14.34,66.12)和 35.58±7.83,其差异有统计学意义(P值均0.05);精神分裂症男性组NLR、IL-6和LYMPH%分别为2.01±0.83、61.96(19.35,128.01)和 31.56±7.42,健康对照男性组分别为 1.59±0.54、31.10(17.67,66.12)和37.13±8.04,其差异有统计学意义(P值均0.05);精神分裂症女性组 NLR、IL-6 和 LYMPH%分别为 2.11±0.77、62.22(21.95,107.19)和30.86±6.34,健康对照女性组分别为 1.82±0.55、25.49(14.34,50.66)和 34.26±7.52,其差异有统计学意义(P值均0.05)。②精神分裂症患者HCY与IL-6呈正相关关系,r值为0.423,其相关性有统计学意义(P0.001)。③精神分裂症患者IL-6与PANSS总分和阴性症状均呈正相关关系,r值分别为0.777和0.861,其相关性均有统计学意义(P值均0.001)。④多因素logistic回归分析结果显示,精神分裂症与IL-6和NLR均密切相关,其 OR 值分别为 1.039(95%CI:1.000～1.014,P0.05)和 1.706(95%CI:1.146～3.869,P0.05)。结论:精神分裂症患者的NLR、IL-6、HCY高于健康者,其中HCY与IL-6呈正相关,其可作为炎症因子在实验室检查或者化验结果支持临床进行诊断,作为诊断依据。IL-6浓度与与精神分裂症PANSS总分及阴性症状分呈正相关,说明其可作为辅助评价精神分裂症病情严重程度及阴性症状的一个生物标记物。NLR、IL-6为精神分裂症患病的影响因素。可以作为精神分裂症患病的预测因子,提高精神分裂症诊断的准确性。
[Abstract]:Objective: to investigate the relationship between immunity and inflammatory response and schizophrenia. Methods: 1 according to the tenth edition of the International Statistical Classification of Diseases and related Health problems (ICD-10), 84 patients with schizophrenia diagnosed in Yanbian brain Hospital from March 2016 to December 2016 were collected, including 43 males. 41 cases were female. Another 52 healthy persons of the same age were selected as the healthy control group, including 24 males and 28 females. 2 the mental symptoms of schizophrenia patients were evaluated by positive and negative symptoms scale (PANSS). 3 the age, sex and marital status of the patients were collected. The BMI value was calculated according to the general data such as height and weight. 4 fasting blood was taken in the morning (fasting for 12 hours) and homocysteine (HCY), C reactive protein (CRP); was detected by automatic biochemical analyzer. The percentage of white blood cell (WBC), red blood cell (RBC), hemoglobin (HGB), blood cell specific volume (HCT), platelet (PLT), neutrophil (NEU%) was measured by automatic blood cell analyzer and matching kit quality control. The percentage of lymphocytes (LYM%), neutrophils (NEU), lymphocytes (LYM), etc., and the neutrophil-lymphocytes ratio (NLR); was calculated. The concentration of IL-6 (IL-6) was determined by enzyme-linked immunosorbent assay (ELISA). 5 the concentration of IL-6 was statistically analyzed by SPSS 20.0 software. The measurement data of normal distribution are represented by mean 卤standard deviation (x 卤SD). T test of independent samples is carried out, and the measurement data of non-normal distribution are represented by median (quartile spacing) [M (P25, P75)]. Mann-WhitneyU test is carried out. The counting data were expressed as percentage, and the 蠂 2 test was carried out. The correlation between IL-6 and its related factors was analyzed by Spearman correlation analysis, and the influence of immune and inflammatory factors on schizophrenia was analyzed by multivariate logistic regression analysis, and the difference was statistically significant (P 0.05). Results: 1in schizophrenia group, NLR,HCY,IL-6 and LYMPH% were 2.06 卤0.80,17.1 (8.65, 28.53), 61.42 (21.42111.96) and 31.22 卤6.88, respectively. The healthy control group was 1.71 卤0.57, 11.20 (8.03, 15.98), 25.61 (14.34, 66.12) and 35.58 卤7.83, respectively, the difference was statistically significant (P 0.05). NLR,IL-6 and LYMPH% in schizophrenia male group were 2.01 卤0.83, 61.96 (19.35128.01) and 31.56 卤7.42, respectively, and those in healthy control male group were 1.59 卤0.54, 31.10 (17.67, 66.12) and 37.13 卤8.04, respectively. The difference was statistically significant (P 0.05). NLR,IL-6 and LYMPH% in schizophrenia group were 2.11 卤0.77, 62.22 (21.95107.19) and 30.86 卤6.34, respectively, while those in healthy control group were 1.82 卤0.55, 25.49 (14.34, 50.66) and 34.26 卤7.52, respectively. The difference was statistically significant (P < 0.05). 2 there was a positive correlation between HCY and IL-6 in patients with schizophrenia (r = 0.423, P < 0.05). The correlation was statistically significant (P0.001). 3 IL-6 was positively correlated with the total score and negative symptoms of PANSS in patients with schizophrenia, r values were 0.777 and 0.861, respectively. The correlation was statistically significant (P = 0.001). 4 the results of multivariate logistic regression analysis showed that schizophrenia was closely related to IL-6 and NLR, and the OR values were 1.039 (95% CI 鈮，

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