首发精神分裂症外周血氧化应激状态改变

摘要

Objective To explore the status of oxidative stress (OS) in the first-episode schizophrenia patients (FEP) and to examine the effects of antipsychotic drugs on oxidative stress of FEP. Methods The plasma total superox⁃ide dismutase (T-SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and total antioxidant capacity (T-AOC) were measured in forty-seven FEP (case group) and forty-three healthy volunteers (control group) before and after treatment. Eighteen cases completed 6-week treatment with risperidone (risperidone group) and twenty-five cases completed 6-week treatment with olanzapine (olanzapine group). Results The activity of T-SOD and GSH-Px were lower (P<0.05) and CAT was higher (P<0.05 ) while there was no significant difference in T-AOC (P>0.05) in FEP compared to the control group. Risperidone and olanzapine significantly improved T-SOD and T-AOC, respectively (P<0.05). There was no significant difference between the two groups in the changes of oxidative stress indicators after treatment (P>0.05). Conclusion FEP has alterations of antioxidant enzymes, which may be related to the pathogenesis of schizo⁃phrenia. Antipsychotics risperidone and olanzapine may improve the oxidative stress in FEP.%目的：探讨首发精神分裂症患者外周血氧化应激变化及抗精神病药治疗对其影响。方法纳入47例首发未用药精神分裂症患者和43名正常对照，测定其外周血总超氧化物歧化酶（total superoxide dis⁃mutase，T-SOD）、谷胱甘肽过氧化物酶（glutathione peroxidase，GSH-Px）、过氧化氢酶（catalase，CAT）及总抗氧化能力（total antioxidant capacity of the body，T-AOC）活性。患者中18例完成单一利培酮6周治疗（利培酮组），25例完成单一奥氮平6周治疗（奥氮平组），治疗后再次测定外周血T-SOD、GSH-Px、CAT及T-AOC。结果与对照组相比，患者组治疗前T-SOD、GSH-Px降低（P<0.05），CAT升高（P<0.05），T-AOC差异无统计学意义（P>0.05）。利培酮组T-SOD活性在治疗后升高（P<0.05），奥氮平组T-AOC在治疗后升高（P<0.05），两组各氧化应激指标的变化值组间差异均无统计学意义（P>0.05）。结论首发精神分裂症患者抗氧化酶活性改变，这可能与精神分裂症病理机制有关。非典型抗精神病药利培酮和奥氮平可改善首发精神分裂症患者的氧化应激状态。