摘要

目的 探讨首发未用药精神分裂症患者氨磺必利治疗前后CD4+CD25+Foxp3+调节性T细胞 (Treg) 及其相关炎性因子水平变化。

方法 选取2021年5月至2021年10月在青岛市精神卫生中心收治的41例首发精神分裂症患者为研究组，同期本院健康职工43例为对照组。检测对照组及研究组治疗前后外周血 CD4+CD25+Foxp3+Treg细胞百分比及转化生长因子 -β(TGF-β)、叉头状转录因子p3(Foxp3)mRNA、白细胞介素-6(IL-6) 和白细胞介素-35(IL-35)水平；分析治疗前后CD4+CD25+Foxp3+Treg 细胞百分比与TGF-β、Foxp3、IL-6和IL-35水平的变化及其与阳性与阴性症状量表（PANSS）减分值的关系。

结果 研究组治疗后PANSS总分及各分量表得分均较治疗前降低（P＜0.05）。治疗后CD4+CD25+Foxp3+Treg细胞百分比、Foxp3 mRNA、血清 IL-35 水平高于治疗前，但仍低于健康对照组，差异均有统计学意义（P<0.05）。治疗后TGF-β mRNA、血清IL-6水平低于治疗前，但仍高于对照组，差异亦均有统计学意义（P<0.05）。治疗前外周血CD4+CD25+Foxp3+Treg细胞百分比与PANSS总分呈负相关（r=-0.910，P＜0.05）。经氨磺必利治疗8周后，治疗前后外周血CD4+CD25+Foxp3+Treg 细胞百分比的变化与PANSS总分减分量之间无相关性(r=-0.148，P=0.354)。

结论 首发精神分裂症患者外周血 CD4+CD25+Foxp3+Treg 细胞及相关炎性因子可能参与疾病的发生发展，且与疾病的转归有关，但在一定时期内Treg 细胞的水平变化与临床症状改善程度不同步。

关键词：精神分裂症；CD4+CD25+Foxp3+Treg细胞；TGF-β；Foxp3；IL-6；IL-35

ABSTRACT

Objective To investigate the change of CD4+CD25+Foxp3+ regulatory T cells (Treg) and the related inflammatory factors in patients with first episode schizophrenia before and after treatment with amisulpride.

Methods 41 patients with first-stage schizophrenia admitted to Qingdao Mental Health Center from May 2021 to October 2021 were selected as the study group, and 43 healthy workers in our hospital were selected as the control group during the same period. The percentage of CD4+CD25+Foxp3+Treg cells and the levels of transforming growth factor-β (TGF-β) ,fork-head transcription factor p3(Foxp3) mRNA, interleukin-6 (IL-6) and interleukin-35 (IL-35) in peripheral blood of the two groups before and after treatment were detected and analyzed. The correlation between the change in percentage of CD4+CD25+Foxp3+Treg cells and the reduction of the Positive and Negative Symptom Scale (PANSS) was analyzed.

Results After treatment, the total score of PANSS and the scores of all subscales in the study group were lower than those before treatment (P<0.05). After treatment, CD4+CD25+Foxp3+Treg cells percentage, FoxP3 mRNA and serum IL-35 level were significantly higher than before treatment, but still lower than healthy control group, with statistical significance (P<0.05). And, TGF-β mRNA and serum IL-6 levels were significantly lower than before treatment, but still higher than healthy control group, and the differences were statistically significant (P<0.05). The percentage of CD4+CD25+Foxp3+Treg cells in peripheral blood before treatment was negatively correlated with the total score of PANSS (r=-0.910, P < 0.05). After 8 weeks of treatment with amsulpride, there was no correlation between the change in percentage of CD4+CD25+Foxp3+Treg cells in peripheral blood before and after treatment and the total reduction of PANSS (r=-0.148, P=0.354)..

Conclusion   The expression of CD4+CD25+Foxp3+Treg cells and related inflammatory factors in peripheral blood of patients with schizophrenia may participate in the occurrence and development of the disease, and are related to the outcome of the disease, but in a certan period of time, the change of Treg cells level is not synchronous with the improvement of clinical symptoms..

Key words: Schizophrenia; CD4+CD25+Foxp3+ Treg cells; TGF-β; Foxp3; IL-6; IL-35