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[精神分裂症患者免疫调节治疗期间虚弱症状复合体的临床和生物学指标动态]

[Dynamics of clinical and biological indices of the asthenic symptom-complex during immunotropic therapy of patients with schizophrenia].

作者信息

Yakimets A V, Zozulya S A, Oleichik I V, Klyushnik T P

机构信息

Mental Health Research Center, Moscow, Russia, Orel Psychiatric Hospital Of A Specialized Type With Intensive Supervision, Orel, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(3):70-76. doi: 10.17116/jnevro20181183170-76.

Abstract

AIM

To identify clinical, psychopathological, and immunological features of the asthenic symptom-complex in patients with schizophrenia and to analyze the possibility of optimizing complex therapy of these conditions using the immunotropic drug bestim.

MATERIAL AND METHODS

Forty-three male patients, aged 20-55 years, were examined. Clinical examination of patients (PANSS, MFI-20) was performed before, and 5, 30 days after the end of treatment. The activity of inflammatory markers (leukocyte elastase (LE) and a1-proteinase inhibitor (a1-PI)) was determined in blood serum.

RESULTS

The affective-asthenic (32.5%) and asthenic-negative (67.5%) variants of the asthenic symptom-complex in schizophrenia characterized by different immune reactions (depending on LE activity) were revealed. Complex therapy with bestim contributed to a statistically significant reduction in the main clinical manifestations of endogenous asthenia in the majority of patients. More significant regression at a remote stage of the study was observed in the astheno-negative group of patients (p<0.001).

CONCLUSION

LE and a1-PI reflect the clinical and biological features of the asthenic symptom-complex which develops within the endogenous process. Normal/reduced activity of LE accompanied by the increased activity of a1-PI is the best predictor of bestim efficacy in terms of reduction of asthenic symptoms.

摘要

目的

确定精神分裂症患者虚弱症状群的临床、精神病理学和免疫学特征,并分析使用免疫调节药物贝司特优化这些病症综合治疗的可能性。

材料与方法

对43名年龄在20 - 55岁的男性患者进行检查。在治疗结束前、结束后5天和30天对患者进行临床检查(阳性和阴性症状量表、多维疲劳量表-20)。测定血清中炎症标志物(白细胞弹性蛋白酶(LE)和α1-蛋白酶抑制剂(α1-PI))的活性。

结果

发现精神分裂症中虚弱症状群的情感性虚弱(32.5%)和虚弱阴性(67.5%)变体具有不同的免疫反应(取决于LE活性)。使用贝司特进行综合治疗有助于大多数患者内源性虚弱的主要临床表现出现统计学上的显著降低。在研究的远期阶段,虚弱阴性患者组观察到更显著的改善(p<0.001)。

结论

LE和α1-PI反映了内源性过程中出现的虚弱症状群的临床和生物学特征。LE活性正常/降低且α1-PI活性增加是贝司特在减轻虚弱症状方面疗效的最佳预测指标。

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