利培酮对首发精神分裂症患者脑源性营养因子的影响

摘要

Objective To observe the effect of risperidone on serum brain derived neurotrophic factor ( BDNF) in first-episode schizophrenic patients. Methods In the treatment group, 90 first-episode schizophrenics were treated with risperidone for 16 weeks, and the dose of risperidone was (3.79±0.88) mg·d-1. Serum BDNF levels were measured before treatment, at 2, 8, and 16 weeks after treatment. The severity of schizophrenia symptoms was assessed by the positive and negative symptom scale ( PANSS) before and after sixteen weeks of treatment. Serum BDNF concentrations were measured in 90 healthy controls. Results BDNF in the control group was (22.867±6.051) ng·mL-1. The serum BDNF levels before treatment and at the end of week 2, 8, 16 after the treatment in the treatment group were (14.256±4.096), (13.078±3.462), (18.001±5.753), (21.089± 6.692) ng·mL-1 , and the serum BDNF level was significantly lower in the treatment group than that in the control group ( P<0.01) . After the treatment, the level of BDNF in the treatment group decreased at first and then increased, compared with that before treatment, the difference was significantly ( P<0.05 or P<0.01) . The level of BDNF in the treatment group at the end of week 16 was not significantly different from that of the control group ( P>0.05) . After treatment, the total score of PANSS scale and its subscales decreased, the difference was significantly (P<0.01). At the end of week 16, the PANSS subscale reduction rate was positively correlated to the serum BDNF concentration change (r=0.499, P=0.001). The change rate of serum BDNF concentration at the end of week 16 was not correlated with the dose of risperidone (r=0.103, P=0.335). Conclusion BDNF is abnormal in the first episode of schizophrenia, which can be improved by risperidone treatment.%目的 观察利培酮对首发精神分裂症患者血清脑源性营养因子(BDNF)的影响.方法 治疗组90例首发精神分裂症患者,给予利培酮治疗16周,利培酮剂量为(3.79±0.88)mg?d-1.在治疗前,治疗第2,8,16周末检测血清BDNF,治疗前及治疗第16周末用阳性与阴性症状量表(PANSS)评定患者精神分裂症症状严重程度.同时测定90名健康对照组血液BDNF浓度.结果 对照组BDNF为(22.867±6.051)ng?mL-1;治疗组治疗前及治疗2,8,16周末血清BDNF水平分别为(14.256±4.096),(13.078±3.462),(18.001±5.753),(21.089±6.692)ng?mL-1,治疗组治疗前明显低于对照组,差异有统计学意义(P<0.01).治疗组治疗后BDNF水平出现先降后升现象,与治疗前比较差异有统计学意义(P<0.05或P<0.01).治疗组治疗16周末,BDNF水平与对照组比较,差异无统计学意义(P>0.05).治疗组治疗后患者PANSS量表总分及各分量表分下降,差异有统计学意义(P<0.01).治疗16周末PANSS量表减分率与血清BDNF浓度变化率正相关(r=0.499,P=0.001).治疗16周末血清BDNF浓度变化率与16周末利培酮剂量无相关性(r=0.103,P=0.335).结论 首发精神分裂症患者存在BDNF异常,利培酮治疗能够获得改善.