李思友

[摘要] 目的 探討是否经历生命早期应激的首发成年男性精神分裂症患者的疗效对比及免疫指标情况。方法 方便选取该院2016年9月—2019年8月期间收治的60例首发成年男性精神分裂症患者作为研究对象，依据是否经历生命早期应激将其分为对照组（n=30）与研究组（n=30），对照组为未经历生命早期应激的成年男性首发精神分裂症患者，研究组为经历生命早期应激的成年男性首发精神分裂症患者，使用奥氮平片进行系统抗精神病治疗，对患者治疗前、治疗4周后的TNF-α、IL-6、IL-1β进行观察，同时观察两组患者治疗2周后、治疗4周后的PANSS氏量表评分减分率情况。结果 治疗前，两组患者的TNF-α、IL-6、IL-1β差异无统计学意义（t=0.001、0.009、0.541，P>0.05）;治疗4周后，对照组的TNF-a、IL-6、IL-1β分别为（97.65±19.47）pg/mL、（125.39±10.28）pg/mL、（113.48±12.97）pg/mL，明显低于研究组的（142.35±13.42）pg/mL、（178.49±15.06）pg/mL、（224.81±16.07）pg/mL，差异有统计学意义（t=10.354、15.950、29.528，P<0.05）;并且对照组的临床治疗总有效率为93.33%，明显高于研究组的70.00%，与研究组相比差异有统计学意义（χ2=5.455，P<0.05）;治疗2周后、治疗4周后研究组的PANSS氏量表评分减分率明显较低，与对照组相比差异有统计学意义（t=10.991、18.931，P<0.05）。结论 相比于未经过生命早期应激的成年男性首发精神分裂症的患者而言，经历生命早期应激的首发成年男性精神分裂症患者的PANSS氏量表评分减分率明显较低，临床治疗效果较差，并且TNF-a、IL-6、IL-1β等指标值均较高。

[关键词] 经历生命早期应激;首发成年男性精神分裂症;免疫指标

[Abstract] Objective To investigate the efficacy comparison and immune index of first adult male schizophrenia patients who experienced early life stress. Methods Sixty patients with first-onset male schizophrenia who were treated in thehospital from September 2016 to August 2019 were convenient selection taken as the research objects. They were divided into control group （n=30） and study group（n=30） based on whether they experienced early life stress， the control group was adult male patients with schizophrenia who did not experience early life stress， and the research group was adult male patients with schizophrenia who experienced early life stress， using olanzapine for systemic antipsychotic treatment， to observe the TNF-a， IL-6 and IL-1β of the patients before and after 4 weeks of treatment， and to observe the reduction rate of the PANSS scale score after 2 weeks and 4 weeks of treatment in the two groups of patients. Results Before treatment， there was no statistically significant difference in TNF-α， IL-6， and IL-1β between the two groups of patients （t=0.001， 0.009， 0.541， P>0.05）. After 4 weeks of treatment， TNF-α， IL-6 and IL-1β were （97.65±19.47） pg/mL， （125.39±10.28） pg/mL， and （113.48±12.97） pg/mL， which were significantly lower than the study group's （142.35±13.42） pg/mL，（178.49±15.06） pg/mL， （224.81±16.07） pg/mL，and the difference was statistically significant（t=10.354， 15.950， 29.528， P<0.05）; and the total effective rate of clinical treatment in the control group 93.33%， significantly higher than the 70.00% of the study group， with statistically significant difference compared with the study group（χ2=5.455， P<0.05）; after 2 weeks and 4 weeks of treatment， the PANSS scale score reduction rate in the study group was significant Lower， compared with the control group（t=10.991， 18.931， P<0.05）. Conclusion Compared with patients with first-onset schizophrenia who have not undergone early life stress， the first adult male with schizophrenia who has experienced early-life stress has a significantly lower PANSS scale score reduction rate and clinical treatment. The effect is poor， and the values of TNF-a， IL-6， IL-1β and other indicators are higher.

[Key words] Experience early life stress; First adult male schizophrenia; Immune indicators

生命早期应激也被称作早期应激或早期创伤[1]。研究中有关精神障碍的病因学研究一直没有定论，遗传学也难以解释所有问题，基因与环境因素的相互作用更容易阐述精神病理学，许多学者把目光投向环境因素[2]。生命早期应激一直是众多研究的焦点，它与成人精神疾病密切相关，生命早期应激可能诱发精神障碍，加重精神症状及增加疾病复发率[3]。生命早期应激是人类成年后多种精神障碍的易感因素[4]。生命早期应激，可能通过基因环境相互作用及表观遗传调控影响神经发育，导致成年后的精神障碍[5]。该文方便选取该院2016年9月—2019年8月期间收治的60例首发成年男性精神分裂症患者作为研究对象，将探讨是否经历生命早期应激的首发成年男性精神分裂症患者的疗效对比及免疫指标情况，现报道如下。