精神分裂症未用药者的暴力行为与甲状腺激素、C反应蛋白的 相关性研究
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天津市科委慢性病防治科技重大专项(17ZXMFSY00070)


Associations between violence behavior and thyroid hormone and C-reactive protein in antipsychotic-naive patients with schizophrenia
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    摘要:

    目的 探讨伴有暴力行为的未用药精神分裂症患者的临床症状特点,分析与甲状腺激素、 C反应蛋白(CRP)水平的相关性。方法 选取2017年11月至2019年12月在天津市安定医院住院的130 例未 用药的精神分裂症患者,根据入院前暴力攻击史分为暴力组(n=72)和非暴力组(n=58),采用阳性与阴性 症状量表(PANSS)评定患者的临床症状,采集患者外周血测定总三碘甲状腺原氨酸(TT3 )、总甲状腺素(TT4 )、 促甲状腺素(TSH)及CRP水平,应用SPSS 23.0统计软件进行数据分析。结果 两组患者的性别、年龄、受 教育程度、婚姻、病程、家族史等方面差异均无统计学意义(P>0.05)。两组的TT4[(99.35±25.37)nmol/L 比(93.87±22.38)nmol/L]、TSH [1.89(1.23,2.47)μIU/ml 比 1.75(1.07,2.62)μIU/ml]水平比较,差异无统 计学意义(P>0.05)。暴力组的TT3[(1.74±0.34)nmol/L比(1.63±0.24)nmol/L]、CRP [1.35(0.47,4.49)mg/L 比 0.61(0.35,1.33)mg/L]水平高于非暴力组,差异有统计学意义(P< 0.05)。两组 PANSS 五维症状中的 兴奋敌对因子[(16.89±3.59)分比(15. 43±3.34)分]、阳性因子[(17.28±3.91)分比(15.43±3.34)分]得 分比较,差异有统计学意义(P< 0.05)。暴力组中的 TT3、CRP 水平与 PANSS 五维症状进行 Spearman 相 关分析未发现明显关联,进一步进行男女性别分组后发现,仅女性 TT3水平与兴奋敌对因子存在正相关 (r=0.378,P< 0.05)。结论 未用药的精神分裂症患者的暴力行为可能与 TT3、CRP 水平存在关联,女性 TT3水平越高,兴奋敌对因子得分更高,有更高的暴力风险。

    Abstract:

    Objective To explore the clinical characteristics of untreated schizophrenic patients with violence, and analyze the correlation between violence and the levels of thyroid hormone and C-reactive protein (CRP). Methods A total of 130 antipsychotic-naive patients with schizophrenia, who were hospitalized in Tianjin Anding Hospital from November 2017 to December 2019 were recruited. According to the history of violent attack before admission, they were divided into violence group (n=72) and non violence group (n=58). The positive and negative symptom scale (PANSS) was used to assess the clinical symptoms of the patients. The levels of total triiodothyronine (TT3 ), total thyroxine (TT4 ), thyrotropin (TSH) and CRP were measured by peripheral blood. The data were analyzed by SPSS 23.0 professional statistical software. Results No significant differences were found in gender, age, education level, marriage, disease course and family history between the two groups (P > 0.05). There were no statistical differences in TT4 [(99.35±25.37) nmol/L vs (93.87±22.38) nmol/L] and TSH [1.89 (1.23,2.47) μIU/mL vs 1.75 (1.07,2.62) μIU/ml] (P>0.05). The level of TT3 [(1.74±0.34) nmol/L vs (1.63±0.24) nmol/L] and CRP [1.35 (0.47, 4.49) mg/L vs 0.61 (0.35, 1.33) mg/L] of the violence group were higher than those of the non violence group, and the differences were statistically significant (P < 0.05). The differences in excitability/hostility factor [(16.89±3.59) vs (15. 43±3.34)] and positive factor [(17.28±3.91) vs (15.43±3.34)] of the five dimensions of PANSS were statistically significant (P< 0.05). Spearman correlation analysis showed no significant correlation between TT3 and CRP levels and PANSS five-dimension symptoms in the violence group. After further gender grouping, it was found that only female TT3 levels were positively correlated with excitability/hostility factors (r=0.378, P < 0.05). Conclusions Violence may be associated with TT3 and CRP in antipsychotic-naive patients with schizophrenia. Female schizophrenics with higher TT3 levels have higher scores of excitability/hostility factor, and are at greater risk of violence.

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蒋长勇 仇玉莹 高营 李洁.精神分裂症未用药者的暴力行为与甲状腺激素、C反应蛋白的 相关性研究[J].神经疾病与精神卫生,2022,22(1):
DOI :10.3969/j. issn.1009-6574.2022.01.004.

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  • 在线发布日期: 2022-01-29