塞来昔布对首发精神分裂症患者炎性细胞因子水平及精神症状影响

Effect of celecoxib on inflammatory cytokine levels and psychotic symptoms in patients with first-episode schizophrenia

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2019, 46(6)
作者
作者单位

南阳医学高等专科第一附属医院 ;

摘要
目的:探讨研究塞来昔布对首发精神分裂症患者炎性细胞因子水平及精神症状的影响。方法:选取2016年6月至2018年6月本院接诊的102例首发精神分裂症患者为研究对象,按照随机数表法将患者分为研究组和对照组,各51例,对照组采用利培酮治疗,研究组在对照组基础上采用塞来昔布治疗,采用副反应量表和阳性和阴性症状量表评定患者副反应状况和精神症状,采用阳性和阴性症状量表减分率评定患者治疗疗效,使用酶联免疫吸附法测定患者白细胞介素-4(interleukin-4,IL-4)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-17(interleukin-17,IL-17)和γ-干扰素(interferon-γ,IFN-γ)水平。结果:治疗4周、6周患者阳性和阴性症状量表一般病理得分、阴性得分、阳性得分和总分均低于基线,且治疗6周患者阳性和阴性症状量表各项得分均低于治疗4周,差异有统计学意义(P<0.05),治疗4周、6周研究组阳性和阴性症状量表阴性得分和总分均低于对照组,差异有统计学意义(P<0.05);治疗4周、6周,两组患者副反应量表评分均降低,差异有统计学意义(P<0.05);治疗6周,两组患者IL-17、IFN-γ和TNF-α水平均下降,且研究组IL-17、IFN-γ和TNF-α水平均低于对照组,差异有统计学意义(P<0.05),随着治疗进行,两组患者IL-4和IL-6均下降,但是差异无统计学意义(P>0.05),治疗后研究组IL-1β水平明显降低,差异有统计学意义(P<0.05);研究组TNF-α水平与阳性和阴性症状量表总分相关系数为0.206(P=0.032),研究组IFN-γ水平与阳性和阴性症状量表阴性得分相关系数为0.359(P=0.010),对照组TNF-α水平与阳性和阴性症状量表总分相关系数为0.351(P=0.013),对照组IFN-γ水平与阳性和阴性症状量表阴性得分相关系数为0.388(P=0.006);治疗6周,研究组总有效率88.23%,高于对照组13.72个百分点,差异有统计学意义(χ2=2.365,P<0.05)。结论:塞来昔布能够改善首发精神分裂症患者精神症状,降低患者炎性细胞因子水平,提高治疗效果。
Abstract
Objective: To investigate the effects of celecoxib on inflammatory cytokine levels and psychiatric symptoms in patients with first-episode schizophrenia. Methods: 102 patients with first-episode schizophrenia who were admitted to our hospital from June 2016 to June 2018 were enrolled. The patients were divided into study group and control group according to the random number table method, 51 cases in each group. Ketone treatment, the study group was treated with celecoxib on the basis of the control group, the side reaction scale and positive and negative symptom scales were used to assess the patients side effects and psychiatric symptoms, and the patients were assessed by the positive and negative symptom scale reduction rate. The therapeutic effect was determined by enzyme-linked immunosorbent assay (ELISA) for interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-1β (interleukin-1β). , IL-1β), tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17) and γ-interferon (interferon-γ, IFN-γ) )Level.Results: The general pathological score, negative score, positive score and total score of the positive and negative symptom scales of patients treated at 4 weeks and 6 weeks were lower than the baseline, and the scores of the positive and negative symptom scales were lower than the treatment for 4 weeks. The difference was statistically significant (P<0.05). The negative and total scores of the positive and negative symptom scales in the study group were lower than those in the control group at 4 and 6 weeks of treatment, and the difference was statistically significant (P<0.05). Weeks and 6 weeks, the scores of the side effects scale of the two groups were decreased, the difference was statistically significant (P<0.05). After 6 weeks of treatment, the levels of IL-17, IFN-γ and TNF-α decreased in both groups, and The levels of IL-17, IFN-γ and TNF-α in the study group were lower than those in the control group, and the difference was statistically significant (P<0.05). With the treatment, IL-4 and IL-6 decreased in both groups, but The difference was not statistically significant (P>0.05). After treatment, the level of IL-1β in the study group was significantly lower (P<0.05). The correlation coefficient between the TNF-α level and the total score of the positive and negative symptom scales in the study group. At 0.206 (P=0.032), the study group had negative IFN-γ levels and positive and negative symptom scales. The correlation coefficient was 0.359 (P=0.010), the correlation coefficient between the TNF-α level of the control group and the total score of the positive and negative symptoms scale was 0.351 (P=0.013), and the IFN-γ level of the control group and the positive and negative symptom scales were negative. The correlation coefficient was 0.388 (P=0.006). The total effective rate of the study group was 88.23% after treatment for 6 weeks, which was 13.72% higher than that of the control group. The difference was statistically significant (χ2=2.365, P<0.05).Conclusion: Celecoxib can improve the mental symptoms of patients with first-episode schizophrenia, reduce the level of inflammatory cytokines in patients, and improve the treatment effect.
关键词
精神症状;精神分裂症;塞来昔布;炎性细胞因子;治疗效果
KeyWord
Psychiatric symptoms; Schizophrenia; Celecoxib; Inflammatory cytokines; Therapeutic effect
基金项目
页码 1000-1002
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袁六六*. 塞来昔布对首发精神分裂症患者炎性细胞因子水平及精神症状影响 [J]. 国际精神病学杂志. 2019; 46; (6). 1000 - 1002.

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