The Effect Of Modified Electroconvulsive Therapy On Cytokines And C-reactive Protein In Patients With Schizophrenia

Objectives To explore the effects of MECT on cytokines and C-reactive protein in schizophrenia. To analysis the disturbance of immune activities in patients with schizophrenia, then explore the mechanism of the MECT to the patients with schizophrenia.Methods The patients with schizophrenia were involved in the research, and healthy people as the control group. The patients in the MECT group and the drug group were in accordance with diagnostic criteria of schizophrenia in the International Classification of Diseases 10th(ICD-10), 16~60 years old, treated with single antipsychotics, risperidone2~8mg/d, quetiapine 300~750mg/d, ziprasidone 80~160mg/d or aripiprazole 10~30mg/d.The patients and their families chose to enter the MECT group or drug group voluntarily.The patients in the MECT group were treated with modified electroconvulsive therapy,which was at least 6 times, 3 times a week, combined with the above antipsychotics. The drug groups were routinely titrated. The concentrations of Interleukin-1(IL-1), interleukin-4(IL-4), interleukin-6(IL-6), interleukin-10(IL-10) and CRP were detected with the blood samples collected from the patients in MECT group before treatment, after the first, the fourth and the sixth treatment immediately, and the drug group before the medication and after the medication of two weeks. The healthy control group was detected just once. The concentrations of IL-1, IL-4, IL-6 and IL-10 were detected by enzyme linked immunosorbent assay(ELISA). The CRP concentration was detected by the latex enhanced immune turbidity method. The symptoms of patients were measured with the PANSS scale. The MECT group was measured before the first treatment and after sixth treatment. The drug group was measured before and after medication. The total score of PANSS, the reducing rate and the effective rate were evaluated.Results 1 58 patients in the MECT group, 41 patients in the drug group, 82 healthy people in the control group were involved in the research. The gender and age of the three groups were matched. 2 The IL-1, IL-6, CRP of the MECT group and the drug group before treatment were significantly higher than the healthy control group(P<0.01), while the IL-4 and IL-10 were not significantly different(P > 0.05). The IL-1, IL-4, IL-6 and CRP of the MECT group and the drug group after treatment were significantly higher than the healthy control group(P<0.01), while the IL-10 were not significantly different(P>0.05). 3 The IL-4, IL-6 and CRP of the MECT group were significantly changed before and after treatment(P<0.05), while the IL-1 and IL-10 were not significantly changed(P>0.05). The IL-4 and CRP of the drug group were significantly changed before and after treatment(P<0.01), while the IL-1, IL-6 and IL-10 were not significantly changed(P>0.05). 4 The total effective rate between MECT group(63.8%) and drug group(24.4%) was significantly different(P<0.01). 5 The IL-1, IL-4, IL-6, IL-10 or CRP values and PANSS score in baseline were not significantly correlated(P>0.05).The variations of IL-1, IL-4,IL-6, IL-10 or CRP and the reducing score rate were not significantly correlated(P>0.05).Conclusions The immune activitiy of patients with schizophrenia is in disturbance. The increased expression of IL-1 may be a marker of diathesis of schizophrenia. MECT may cause the increase of IL-4, IL-6 and CRP, but the dynamic change in 24 hours or in firstepisode schizophrenia and the long-term effect needs further study.