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精神分裂症中生物标志物的变化及治疗效果

The changes of biological markers and treatment efficacy in schizophrenia.

作者信息

Cesková E, Drybcák P, Hrobar P, Lorenc M, Spacek J

机构信息

Department of Psychiatry, Masaryk University, Brno, Czech Republic.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2001 Feb;25(2):323-35. doi: 10.1016/s0278-5846(00)00164-0.

DOI:10.1016/s0278-5846(00)00164-0
PMID:11294479
Abstract
  1. In a group of schizophrenic patients, the effect and selected parameters of biological markers were evaluated during the index hospitalisation in the acute phase of schizophrenia (n = 30) and then after one year of ambulatory treatment. 2. During the acute treatment, a significant drop in symptomatology was recorded in average; an analogical tendency was observed further on, too. Apart from that, a significant change was observed in 5/41 parameters being monitored (the pair t-test): I) decrease in the total NES score, II) decrease in the sensorial integration subscale NES score, III) increase in psychomotor speed, IV) decrease in auditory reaction time, V) increase in basal cortisol. 3. In the comparison of the successfully (severity of illness after one year = 1, 2) and unsuccessfully (severity of illness after one year > or =3) treated patients in the beginning of treatment in the acute phase, the unsuccessful group had a significantly higher score of negative symptomatology, and by the end of the acute treatment, again, a significantly higher score of negative symptomatology, a higher total PANSS score and a greater severity of illness. 4. In the acute phase, the successful group had a significantly better score in individual items of the Contemporary Memory Scale and a significantly worse performance and goal-aimed concentration in the Bourdon test than the unsuccessfully treated one; apart from that, it had a significantly higher cortisol level after dexamethasone, which was also reflected in the lower percentage rate of dexamethasone nonsupression. 5. In the course of the year, a drop in the total NES score for the individual subscales occurred; a significant drop was observed in the sensory integration subscale. The worse concentration items improved significantly in the successful group in contrast to the unsuccessful group, where they showed a downgrade tendency. Changes in Contemporary Memory Scale were negligible and mostly below statistical significance. Apart from that, a drop in basal cortisolemia occurred in the successful group and an increase in cortisolemia after administering dexamethasone was registered in the unsuccessful group. 6. The more successful group had a significantly lower NES score, a significantly better visual reaction time and a smaller forgetting item (in percentiles) after the one-year period.
摘要
  1. 在一组精神分裂症患者中,对生物标志物的效应和选定参数在精神分裂症急性期的首次住院期间(n = 30)进行了评估,然后在门诊治疗一年后再次评估。2. 在急性治疗期间,平均症状有显著下降;之后也观察到类似趋势。除此之外,在监测的41项参数中有5项出现了显著变化(配对t检验):I)总NES评分降低,II)感觉统合分量表NES评分降低,III)精神运动速度加快,IV)听觉反应时间缩短,V)基础皮质醇升高。3. 在急性期治疗开始时,比较成功治疗(一年后疾病严重程度=1、2)和未成功治疗(一年后疾病严重程度≥3)的患者,未成功组的阴性症状评分显著更高,到急性治疗结束时,同样,阴性症状评分显著更高、总PANSS评分更高且疾病严重程度更高。4. 在急性期,成功组在当代记忆量表的各个项目上得分显著更好,在布尔东测试中的表现和目标导向注意力显著更差;除此之外,地塞米松后的皮质醇水平显著更高,这也反映在地塞米松不抑制的百分率更低。5. 在这一年中,各个分量表的总NES评分下降;感觉统合分量表出现了显著下降。与未成功组相比,成功组中较差的注意力项目有显著改善,而未成功组则呈现下降趋势。当代记忆量表的变化可忽略不计,大多低于统计学显著性。除此之外,成功组基础皮质醇血症下降,未成功组地塞米松给药后皮质醇血症升高。6. 较成功组在一年期后NES评分显著更低、视觉反应时间显著更好且遗忘项目更小(以百分位数计)。

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