| ObjectiveThe serum levels of IL-6 and CRP in 62 cases of treatment-resistant schizophrenia patients with negative symptoms were measured and compared with 29 healthy people,and the immune state of patients with treatment-resistant schizophrenia was observed and discussed.The effect of escitalopram as a synergist on negative symptoms was compared,and compared with the placebo group by measuring the change of negative symptoms in patients with schizophrenia before and after the use of escitalopram as a synergist and compared with the placebo group.And the effect of escitalopram on the negative symptoms of patients with treatment-resistant schizophrenia was investigated.To observe the effects of escitalopram on the immune factors by detecting the changes of cytokines IL-6 and CRP before and after the treatment of escitalopram,and to explore the potential immune mechanism of escitalopram as an synergist in improving the symptoms of treatment-resist ant schizophrenics.By observing the changes of the negative and cognitive symptoms of the schizophrenic patients before and after the treatment,and the correlation analysis with the cytokines,the correlation between the severity of the negative symptoms of schizophrenia and the cytokine is observed,and the possible basis for clinical treatment is provided.MethodAccording to the diagnosis of treatment-resistant schizophrenia,62 patients with treatment-resistant schizophrenia and 29 healthy subjects were included in the patient group and the healthy group respectively.The serum levels of the two groups of IL-6 and CRP were detected by chemical analysis,and the differences were compared.A randomized,double blind(evaluator and patient)placebo control method was used to randomly give 62 patients to escitalopram or placebo for 8 weeks of treatment,and 8 weeks later,they were divided into the treatment group and the placebo group.Blood samples were collected before treatment and 8 weeks after treatment.Serum levels of IL-6 and CRP were measured in treatment group and placebo group.On the day of 2 blood fetching,the data of the patients were collected by inquiring about the condition,the mental examination and the physical examination,and the PANSS scale of the schizophrenic patients was evaluated.In this study,the PANSS scale was assessed two times(baseline,8 weeks).The differences of IL-6 and CRP levels and PANSS scales were compared between the two groups at baseline and 8 weeks.The correlation analysis and regression analysis were carried out respectively on the five factors of the patients and the level of cytokines at baseline and 8 weeks respectively.All data were statistically analyzed with SPSS18.0.Result1.There was a significant difference in the levels of cytokines IL-6 and CRP between the healthy control group and the patients group(p<0.05).The serum IL-6(0.80±0.66 pg/mL)and CRP levels(4.17±7.01 mg/L)in the patients group were significantly higher than the serum IL-6(1.14±0.87 pg/mL)and CRP(0.80±0.66 mg/L)level in the healthy control group(p<0.01).The two groups(treatment group and placebo group)were similar in age,course of disease,plasma,triglyceride,blood glucose,high density lipoprotein,cholesterol and prolactin levels(p>0.05).2.At baseline,there was no significant difference in the total score of PANSS and symptom scores between the two groups(treatment group and placebo group).After 8 weeks of treatment,the total PANSS score,negative symptoms and emotional symptoms scores in the treatment group were significantly reduced compared with the placebo group(p<0.05).There was no difference in the positive and aggressive factors between the two groups.3.At baseline,there was no significant difference in the levels of IL-6 and CRP between the two groups(treatment group and placebo group)(p>0.05).After 8 weeks,the serum CRP level of the two groups decreased,but there was no significant difference between the two groups(p>0.05).There was no significant difference between the two groups(F=0.636,p=0.594).The serum IL-6 water in the two groups decreased significantly,and there were significant differences between the groups after 8 weeks(p>0.05).There were significant differences before and after the whole treatment(F=2.652,p =0.049),and there was a significant difference(t=5.421,p=0.000)before and after treatment.4.At baseline,the level of serum IL-6 in the two groups was moderately positive with negative symptoms(r=0.440,p=0.001)and cognitive symptoms(r=0.503,p<0.001),and there was no correlation between the level of CRP and all the symptoms.At 8 weeks,serum IL-6 level was positively correlated with negative symptoms and cognitive symptoms(r =0.477.p = 0.050).There was no correlation between the CRP level and all the symptoms.5.At baseline,the ratio of IL-6 le-vels to the total variation of negative symptoms was 16.2%,accounting for 20.1%of the total variation in cognitive symptoms.At 8 weeks,the ratio of variance explained by IL-6 level accounted for 22.7%of the total variance of negative symptoms,accounting for 20.8%of the total variance of cognitive symptoms.At baseline and 8 weeks,CRP levels had little effect on negative symptoms.Conclusion1.The level of cytokine IL-6 in patients with t re atment-resist ant schizophrenia is higher than healthy people,and may be useful for the severity of patients with treatment-resistant schizophrenia.2.The level of cytokine CRP in refractory schizophrenics is higher than healthy people.3.Escitalopram is a safe and effective drug.It has a synergist effect on the negative symptoms of schizophrenia.4.The level of cytokine serum IL-6 in schizophrenic patients has a positive correlation with negative symptoms and cognitive symptoms,and has no significant correlation with positive symptoms and emotional symptoms and attack symptoms.The regulation of IL-6 levels of cytokines in the brain of schizophrenic patients may improve the negative symptoms and cognition of patients with schizophrenia.5.these changes may be part of the effective mechanism of clinical effective drugs,and can be used to observe the prognosis of treatment-resistant negative symptoms.6.The mechanism of escitalopram to improve the negative symptoms is considered to be related to immune factors. |
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