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复发精神分裂症患者免疫炎症指标表达与糖脂代谢异常的关系

Relationship between expression of immune inflammationindicators and abnormal glucose as well as lipid metabolism in patients with recurrent schizophrenia

    摘要
  • 摘要:
      目的  探讨复发精神分裂症患者中性粒细胞与淋巴细胞比值（NLR）、超敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）、红细胞分布宽度（RDW）及抗核抗体（ANA）等免疫炎症指标表达情况及其与糖脂代谢异常的关系。
      方法  选取复发精神分裂症患者70例纳入病例组，并选取同期健康体检者48例纳入对照组，比较2组NLR、RDW、hs-CRP、Hcy及ANA表达情况。从病例组中选取经一线第2代抗精神病药物连续规范治疗达1个月的33例患者，比较其治疗前后NLR、RDW、hs-CRP、Hcy表达情况。采用单因素及多因素二元Logistic回归分析探讨NLR、RDW、hs-CRP、Hcy与病例组患者伴发糖脂代谢异常的关系。
      结果  病例组入院时NLR、RDW、hs-CRP、Hcy表达水平高于对照组，差异有统计学意义（P < 0.05），2组ANA表达情况差异无统计学意义（P>0.05）；经一线第2代抗精神病药物连续规范治疗1个月后，33例患者的NLR低于入院时，差异有统计学意义（P < 0.05），但RDW、hs-CRP、Hcy水平与治疗前比较，差异无统计学意义（P>0.05）；Logistic回归分析显示，NLR、年龄与复发精神分裂症患者伴发血糖代谢异常风险显著相关（OR=1.799、1.063，P < 0.05），hs-CRP、年龄与复发精神分裂症患者伴发血脂代谢异常风险显著相关（OR=1.273、1.031，P < 0.05）。
      结论  Hcy、hs-CRP、NLR、RDW可能在复发精神分裂症发病机制中发挥着重要作用，NLR、hs-CRP可能与复发精神分裂症患者伴发糖脂代谢异常有关。

     

    Abstract:
      Objective  To investigate the expressions of immune inflammation indicators, such as the neutrophil-to-lymphocyte ratio (NLR), high sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), red blood cell distribution width (RDW) and antinuclear antibody (ANA) in patients with recurrent schizophrenia, and their relationships with abnormal glucose and lipid metabolism.
      Methods  A total of 70 patients with recurrent schizophrenia were selected as case group, and 48 healthy subjects were selected as control group. The expressions of NLR, RDW, hs-CRP, Hcy and ANA were compared in two groups. A total of 33 patients who were treated with first-line second generation antipsychotics for 1 month were selected from the case group, and the expressions of NLR, RDW, hs-CRP and Hcy before and after treatment were compared. The univariate and multivariate binary Logistic regression analysis were used to analyze the relationships between the immune inflammatory indicators such as NLR, RDW, hs-CRP, Hcy and the abnormal glucose as well as lipid metabolism in patients in the case group.
      Results  The NLR, RDW, hs-CRP and Hcy in the case group were significantly higher than those in the control group at admission(P < 0.05). There was no difference in ANA between two groups (P>0.05).The NLR levels of 33 patients who received first-line second-generation antipsychotic treatment for 1 month were lower than those at admission (P < 0.05). There were no differences in RDW, hs-CRP and Hcy levels before and after treatment (P>0.05). Logistic regression analysis showed that NLR and age were significantly correlated with abnormal fasting glucose metabolism in patients with recurrence of schizophrenia (OR=1.799, 1.063, respectively, P < 0.05), hs-CRP and age were correlated with abnormal lipid metabolism in patients with recurrent schizophrenia (OR=1.273, 1.031, respectively, P < 0.05).
      Conclusion  Hcy, hs-CRP, NLR and RDW may play important roles in the pathogenesis of recurrent schizophrenia. The NLR and hs-CRP levels may be related to abnormal glucose and lipid metabolism in patients with recurrent schizophrenia.

     

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