本刊首页 > 期刊目次 > 米诺环素辅助利培酮对早期精神分裂症患者阴性症状及认知功能的改善作用机制

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米诺环素辅助利培酮对早期精神分裂症患者阴性症状及认知功能的改善作用机制

  • 胡军,盛民生,胡长春,原琳琳

* 通信作者: 胡军, 单位:河南省洛阳荣康医院

摘要

【摘要】
目的 探讨米诺环素辅助利培酮对早期精神分裂症患者阴性症状及认知功能的改善作用机制。

方法 选取2014年8月至2016年7月我院收治的早期精神分裂症患者86例为研究对象,按入院顺序编号后采用随机数表法分为观察组和对照组各43例,对照组给予利培酮+安慰剂,观察组给予米诺环素+利培酮,均治疗16周,以阴性症状量表(SANS)、阳性症状量表(SAPS)、阳性和阴性症状评定量表(PANSS)评价两组治疗前后精神症状,采用精神分裂症认知功能成套测验(MCCB)评估认知功能,测定两组血清白介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)、脑源性神经营养因子(BDNF),并观察不良反应。

结果 观察组治疗有效率86.0%较对照组67.4%高(P<0.05);治疗后观察组SANS评分(32.19±1.22)分、SAPS评分(6.38±1.35)分、PANSS评分(38.41±1.06)分均较对照组显著下降(P<0.05);治疗后两组MCCB评分均有所升高,且观察组对注意/警觉领域评分(1.99±0.65)分明显高于对照组(P<0.05);治疗后观察组血清IL-1β(5.30±0.12)pg/ml、TNF-α(2.19±1.40)pg/ml低于对照组,观察组BDNF(24.19±1.06)ng/ml较对照组升高(P<0.05);两组不良反应发生率20.9%、18.6%比较无显著差异(P>0.05)。

结论 米诺环素辅助利培酮可有效治疗早期精神分裂症,可能通过降低IL-1β、TNF-α、升高BDNF水平而改善患者阴性症状及认知功能,值得在临床推广应用。

关键词:【关键词】米诺环素;利培酮;早期精神分裂症;阴性症状;认知功能

ABSTRACT

[Abstract]
Objective To explore the mechanism of minocycline combined with risperidone in relieving negative symptoms and improving cognitive function in patients with early schizophrenia.

Methods Eighty-six patients with early schizophrenia who were admitted to the hospital between August 2014 and July 2016 were selected as study subjects. According to the order of admission, the patients were numbered and were randomly divided into the observation group and the control group, 43 cases in each group. The control group were treated with risperidone and placebo while the observation group were treated with risperidone and minocycline. Both groups were treated for 16 weeks. The psychiatric symptoms were evaluated with negative symptom scale (SANS), positive symptom scale (SAPS) and positive and negative symptom scale (PANSS) before and after treatment, and the cognitive function was evaluated with cognitive test battery for schizophrenia (MCCB). The serum interleukin -1β (IL-1β), tumor necrosis factor α (TNF- α) and brain-derived neurotrophic factor (BDNF) were determined, and the adverse reactions were observed.

Results The effective rate of treatment in the observation group (86.0%) was higher than that in the control group (67.4%) (P<0.05). After treatment, the scores of SANS, SAPS and PANSS in the observation group [(32.19±1.22), (6.38±1.35), (38.41±1.06)] were significantly lower than those in the control group (P<0.05). After treatment, MCCB scores of the two groups were all increased, and the score of attention / vigilance in the observation group (1.99±0.65) was significantly higher than that in the control group (P<0.05). After treatment, the levels of serum IL-1β and TNF- α in the observation group [(5.30±0.12) pg/ml, (2.19±1.40) pg/ml] were lower than those in the control group, while the BDNF level [(24.19±1.06) ng/ml] was higher than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (20.9% vs 18.6%) (P>0.05).

Conclusion   Minocycline combined with risperidone is effective in the treatment of early schizophrenia. It may relieve the negative symptoms and improve cognitive function by reducing IL-1β and TNF-α and increase BDNF level.

Key words: [Key words] Minocycline; Risperidone; Early schizophrenia; Negative symptoms; Cognitive function

引用本文 / How to Cite This Article

胡军,盛民生,胡长春,原琳琳. 米诺环素辅助利培酮对早期精神分裂症患者阴性症状及认知功能的改善作用机制[J]. 国际精神病学杂志, 2017, 44(3): 417-419

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