慢性精神分裂症男性患者血浆一氧化氮及其合成酶活性的 临床研究
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江苏省卫健委面上项目(H2018041),苏州市临床重点病种诊疗技术专项(LCZX201919)


Clinical study of plasma nitric oxide and its synthetase activity in male patients with chronic schizophrenia
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    摘要:

    目的 探讨慢性精神分裂症男性患者血浆一氧化氮(NO)浓度及其合成酶活性与患者认 知功能和临床症状之间关系。方法 于 2020 年 1— 10 月在连云港地区精神专科医院(连云港市第四人 民医院、赣榆区康复医院、东海县精神病医院、灌云县精神病医院)选取 96 例慢性精神分裂症男性患 者作为患者组,同期在连云港市招募年龄 18~60 岁的 88 例健康男性作为对照组,进行血浆 NO 浓度和 原生型一氧化氮合酶(cNOS)、诱导型一氧化氮合酶(iNOS)活性检测,采用重复性成套神经心理状态评 定量表(RBANS)对所有研究对象测量认知功能,采用阳性与阴性症状评定量表(PANSS)对患者组进行 精神症状评估。结果 患者组的 NO 水平高于对照组[(53.1±16.7)μmol/L 比(48.0±16.8)μmol/L],差 异有统计学意义(P=0.017);患者组的 cNOS 活性低于对照组[(1.3±0.5)U/ml 比(1.6±0.5)U/ml],差异有 统计学意义(P< 0.001)。两组的 iNOS 活性比较,差异无统计学意义[(1.7±0.5)U/ml 比(1.6±0.7)U/ml, P=0.160]。患者组的 RBANS 总分及 5 个分量表评分显著低于对照组(均P< 0.01)。在患者组中,NO 浓 度与体重指数(BMI)(r=0.353,P< 0.001)、病程(r=0.257,P=0.012)、PANSS 阳性症状分(r=0.331,P=0.001)、 PANSS 一般病理分(r=0.204,P=0.047)呈正相关,而与发病年龄(r=-0.320,P=0.001)、RBANS 中的言 语功能评分(r=-0.281,P=0.005)呈负相关。患者组的 cNOS 和 iNOS 活性与临床特征、PANSS 评分及 RBANS 评分无明显相关性(均P> 0.05)。患者组的低 NO 浓度组[(39.6±10.6)μmol/L]较高 NO 浓度组 [(66.2±9.5)μmol/L]在言语功能[(76.1±11.3)分比(68.5±14.3)分]方面差异有统计学意义(P< 0.05)。 结论 慢性精神分裂症男性患者认知功能明显受损,血浆 NO 及其合成酶活性存在异常,且血浆 NO 与 患者的临床特征存在关联性,提示氧化应激机制在精神分裂症病理生理机制中可能起到一定作用。

    Abstract:

    Objective To investigate the relationship between plasma nitric oxide (NO) concentration, nitric oxide synthase (NOS) activity and cognitive function and clinical symptoms in male patients with chronic schizophrenia. Methods A total of 96 male patients with chronic schizophrenic were selected as the patients group in Lianyungang psychiatric hospitals (The Fourth People's Hospital of Lianyungang, Rehabilitation Hospital of Ganyun District, Psychiatric Hospital of Donghai, Psychiatric Hospital of Guanyun) from January to October 2020. Another 88 healthy male aged from 18 to 60 were recruited from January to October 2020 in Lianyungang as the control group. The plasma nitric oxide (NO) concentration and the activities of primary nitric oxide synthase (cNOS) and inducible nitric oxide synthase (iNOS) were detected. The cognitive function of all the research objects was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The Positive and Negative Syndrome Scale (PANSS) was used to evaluate the mental symptoms of the patients. Results The level of NO in the patient group was higher than that in the normal group [(53.1±16.7) μmol/L vs (48.0±16.8) μmol/L], and the difference was statistically significant (P=0.017). The activity of cNOS in the patient group was lower than that in the normal group [(1.3±0.5) U/ml vs (1.6±0.5) U/ml], with statistical significance (P< 0.001). There was no significant difference in the activity of iNOS between the two groups [(1.7±0.5) U/ml vs (1.6±0.7) U/ml, P=0.160]. The total score of RBANS and five subscales in the patient group were significantly lower than those in the control group (all P < 0.01). In the patient group, NO concentration was positively correlated with body mass index (BMI) (r=0.353, P < 0.001), course of disease (r=0.257, P=0.012), PANSS positive symptom score (r=0.331, P=0.001), PANSS general pathological score (r=0.204, P=0.047), and negatively correlated with age of onset (r=-0.320, P=0.001), the score of speech function of RBANS (r=-0.281, P=0.005). There was no significant correlation between the activity of cNOS and iNOS and clinical features, PANSS score and RBANS score in the patient group (all P > 0.05). There was significant difference in speech function [(76.1±11.3) vs (68.5±14.3), P < 0.05] between low NO concentration group [(39.6±10.6)μmol/L] and high NO concentration group [(66.2±9.5)μmol/L]. Conclusions The cognitive function of chronic male schizophrenia is significantly impaired. The activities of plasma NO and its synthase are abnormal, and there is a correlation between plasma NO and the clinical characteristics of patients, suggesting that the mechanism of oxidative stress may play a role in the pathophysiological mechanism of schizophrenia.

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杨曼 杨海东 闫琳雅 刘栋梁 时金艳 张晓斌.慢性精神分裂症男性患者血浆一氧化氮及其合成酶活性的 临床研究[J].神经疾病与精神卫生,2022,22(1):
DOI :10.3969/j. issn.1009-6574.2022.01.005.

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  • 在线发布日期: 2022-01-29