摘要目的 观察首发未用药精神分裂症患者血清氧化应激指标和脑源性神经营养因子(BDNF)及其与认知功能的关系,探讨氧化应激在首发精神分裂症患者认知功能损害中的可能作用.方法 选取2016年3月至2017年9月至郑州大学第一附属医院精神科就诊的首发未用药精神分裂症患者125例(患者组)和同期的健康志愿者80名(健康对照组),采用微量酶标法检测血清氧化型谷胱甘肽(GSSG)水平,采用一步法检测血清一氧化氮(NO)水平,采用酶联免疫吸附法检测血清BDNF水平,采用精神分裂症认知功能成套测验(MCCB)评估认知功能.结果 (1)患者组血清BDNF水平[(2763±1728) pg/ml]明显低于健康对照组[(4165±1299) pg/ml],血清GSSG、NO水平患者组[(36±9)、(81±65)μmol/L]明显高于健康对照组[(27±11)、(24±16)μmol/L],差异均有统计学意义(均P＜0.001).与健康对照组相比,患者组在认知功能七大领域中的得分下降较为明显(均P＜0.001);(2)相关分析显示:采用偏相关分析控制年龄、性别、文化程度、病程等混杂因素后,患者组血清BDNF水平与认知功能七大领域中的信息处理速度(SOP)T分、注意与警觉(CTP-IP)T分、工作记忆(WMS-Ⅲ)T分、推理和问题解决(NAB)T分均正相关(r=0.417、0.206、0.247、0.318,均P＜0.05),患者组GSSG水平与认知功能七大领域中SOPT分和NABT分均负相关(r=-0.321、-0.231,均P＜0.05),患者组NO水平与SOPT分、WMS-Ⅲ T分、词语学习(HVLT)T分均负相关(r=-0.201、-0.193、-0.237,均P＜0.05).结论 氧化应激系统可能参与精神分裂症认知功能损害的过程,氧化产物是精神分裂症认知功能损害的危险因素,BDNF是认知功能的保护因素.

abstractsObjective To observe the relationship between serum oxidative stress as well as brain-derived neurotrophic factor (BDNF) and cognitive function in first-episode drug-free schizophrenics,and to explore the possible effect of oxidative stress in cognitive impairment of first-episode schizophrenia.Methods A total of 125 first-episode drug-free schizophrenics (schizophrenia group) from the First Affiliated Hospital of Zhengzhou University and 80 healthy individuals (control group) were enrolled.The serum concentration of oxidized glutathione (GSSG) was measured by the Microenzyme method the serum concentration of nitric oxide (NO) was measured by one-step method,the BDNF level was measured by enzyme linked immunosorbent assay and Matrics Consensus Cognitive Battery(MCCB) was used to evaluate the cognitive function.Results (1)The serum level of BDNF in schizophrenia group (2763± 1728 pg/ml) was significantly lower than that in control group (4165±1299 pg/ml)(P＜0.001).And the serum levels of GSSG and NO in schizophrenia group ((36±9),(81+65) μmol/L) were significantly higher than that in control group ((27±11),(24±16) μmol/L) (P＜0.001).In comparison with the control group scores were significantly lower in the seven domains of cognitive function in the schizophrenia group (all P＜0.001).(2)After controlling the confounding factors like age,gender,cultural differences and course of disease by partial correlation analysis,the correlation analysis showed that:serum level of BDNF in schizophrenia group had positive correlation with Information processing rate T points,attentional facilitating T points,working memory T points and Reasoning and problem solving T points (r=0.417,0.206,0.247,0.318,all P＜0.05).In schizophrenia group the serum level of GSSG had a negative correlation with information processing rate T points and reasoning and problem solving T points (r=-0.321,-0.231,all P＜0.05).The serum level of NO was negatively related to Information processing rate T points working memory T points Verbal learning T points(r=-0.201,-0.193,-0.237,all P＜0.05).Conclusions Oxidative stress may be involved in the cognitive impairment of schizophrenia Oxidation products are risk factors for cognitive impairment of schizophrenia and BDNF is a protective factor of cognitive function.