摘要
目的探讨氯氮平治疗精神分裂症有顽固性幻听患者疗效与血清N-甲基-D-天冬氨酸(N-Methyl-D-aspartic acid,NMDA)抗体浓度相关性研究。方法精神分裂症有顽固性幻听住院患者30例为病例组。健康体检者30例为对照组。采用平行对照试验,进行一般人口学资料、治疗前、治疗6周后阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评分、NMDA抗体浓度比较及相关性分析。结果一般人口学资料显示差异无统计学意义(P>0.05);病例组治疗6周后PANSS总分(t=22.099)、阳性症状分(t=15.097)、阴性症状分(t=3.800)及一般病理评分(t=14.888)均低于治疗前(P<0.001)。病例组治疗前后及对照组NMDA抗体两两比较,发现均有显著性差异(t=7.062,2.089,9.697,P<0.05);经pearson相关分析,病例组治疗前抗NMDA抗体浓度与PANSS总分存在正相关(r=0.522,P=0.002),治疗后NMDA抗体浓度与PANSS总分无统计学意义相关(r=0.100,P=0.598)。结论精神分裂症有顽固性幻听患者通过氯氮平治疗后临床症状改善,NMDA抗体浓度下降,其作用机制有谷氨酸及其他通路参与,NMDA抗体可能是谷氨酸代谢相关生物标志物之一。
Objective To investigate the correlation between the therapeutic effect of clozapine and the concentration of serum NMDA antibody in the treatment of schizophrenic auditory hallucinations.Methods A total of 30 patients with schizophrenic auditory hallucinations eligible for observation in our hospital from November 2020 to April 2021 were included as the case group.In addition,30 healthy people who underwent physical examination in our hospital during the same period were collected as the control group.A parallel control test was conducted to compare and analyze the general demographic data,PANSS scores,serum NMDA antibody concentrations and the relationship between the two groups before treatment and 6 weeks after treatment.Results There was no significant difference in general demographic data between case group and control group(P>0.05);After 6 weeks of treatment,the total score of PANSS(t=22.099),positive symptom score(t=15.097),negative symptom score(t=3.800)and general pathological score(t=14.888)in the case group were lower than those before treatment(P<0.001).There were significant differences in serum NMDA antibody concentration between the case group and the control group before and after treatment(t=7.062,2.089,9.697,P<0.05).The pearson correlation analysis showed that serum NMDA antibody concentration was positively correlated with the total score of PANSS before treatment(r=0.522,P=0.002),But there was no statistically significant correlation between serum NMDA antibody concentration and the total score of PANSS after treatment(r=0.100,P=0.598).Conclusion The clinical symptoms and serum NMDA antibody concentration of schizophrenic auditory hallucinations patients were significantly improved after clozapine treatment,The serum NMDA antibody concentration before treatment was correlated with the total score of PANSS.It is considered that glutamate pathway is involved in the mechanism of clozapine treatment of schizophrenic auditory hallucinations patients,and other pathways are also involved.The serum NMDA antibody may be one of the biomarkers related to glutamate metabolism.
作者
张莉
张红艳
李静
吾拉木
李霞
杨超
ZHANG Li;ZHANG Hongyan;LI jing;Wulamu;LI Xia;YANG Chao(The Fourth People’s Hospital of Urumqi,Urumqi,830000,China)
出处
《新疆医学》
2024年第8期931-934,共4页
Xinjiang Medical Journal
基金
乌鲁木齐市卫生健康委科技计划项目(项目编号:202029)
作者简介
张莉,女,主任医师,研究方向:精神病学;通信作者:杨超,女,主任医师,研究方向:精神病学。E-mail:lily19822004@126.com
