摘要
目的研究髓鞘特异性蛋白及与其他相关的其他蛋白在早发性精神分裂症(EOS)患者血清中的水平变化,从临床症状和诊断两方面寻找潜在EOS生物标记物。方法选择30例EOS儿童作为EOS组,以及30例与其年龄、性别比例匹配的正常发育儿童作为对照组。采用以下方法进行研究(1)ELISA检测以下髓鞘相关蛋白因子血清浓度髓鞘碱性蛋白(MBP)、髓鞘少突胶质细胞糖蛋白(MOG)、髓鞘相关糖蛋白(MAG)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)、可溶性蛋白(S100β)、胶质纤维酸性蛋白(GFAP),并对EOS组进行阳性与阴性症状量表(PANSS)评定;(2)Spearman分析各蛋白因子与PANSS总分和各症状因子得分的相关性;(3)采用逻辑回归分析筛选对EOS诊断价值较高的指标,建立诊断理论模型,并绘制受试者工作特征(ROC)曲线评价此模型的诊断价值。结果EOS组MBP血清水平高于对照组(P<0.05),MAG、BDNF、NGF、S100β和GFAP血清水平低于对照组(P<0.05)。EOS组MBP与PANSS总分及阴性症状因子分均呈正相关(P<0.05)。逻辑回归分析筛选出MBP、BDNF两个蛋白指标(P<0.05),由此得出诊断模型Logistic(P),该模型对本研究纳入的样本诊断准确率为91.3%。ROC曲线分析显示此模型曲线下面积为0.9659,灵敏度为91.67%,特异度为95.45%,似然比为20.17。结论EOS血清髓鞘相关蛋白因子浓度变化表明EOS患者可能存在髓鞘异常,MBP有望成为反映EOS症状严重程度的指标,其与BDNF结合,对早期精神分裂症的辅助诊断有一定的价值。
Objective The abnormalities of pathological changes in myelin have been reported in patients with Early Onset Schizophrenia(EOS).Myelin Basic Protein(MBP),Myelin Oligodendrocyte Glycoprotein(MOG),and Myelin Associated Glycoprotein(MAG)are all myelin specific proteins,which are specific indicators of myelin status.In addition,Brain Derived Neurotrophic Factor(BDNF),Nerve Growth Factor(NGF),Soluble Protein(S100β),Glial Fibrous Acidic Protein(GFAP)have been confirmed to be involved in myelin injury and protection.Therefore,it can be hypothesized that pathological changes in myelin of EOS may lead to abnormal expressions of these proteins in peripheral blood.By studying the changes in serum levels of myelin specific proteins and their related proteins in EOS patients,it is expected to find potential biomarkers for EOS from clinical symptoms and diagnoses.Methods 30 EOS children with a mean age of(14.0±1.4)years old who were drug-naive or had not used antipsychotics for at least 3 months were selected as the EOS group,and 30 normal developing children matching their age and gender ratio were selected as control group.The following methods were used in this study:(1)Serum concentrations of myelin related factors were detected by Enzyme Linked Immunosorbent Assay(ELISA):MBP,MOG,MAG,BDNF,NGF,S100β,GFAP;patients in EOS group were assessed with Positive and Negative Syndrome Scale(PANSS);(2)Spearman analysis was used to explore the correlations among all protein factors and the total score and all factor scores of PANSS;(3)Logistic regression analysis was used to screen indicators with high diagnostic value for EOS,and establishing a diagnostic model,as well as using a receiver operating characteristic(ROC)curve to evaluate the diagnostic value of this model.Results Serum concentration of MBP[1268.0(961.2)ng/L]in EOS group was significantly higher than that in control group[627.0(868.9)ng/L];serum concentrations of MAG[485.9(87.4)ng/L],BDNF[1900.0(322.0)ng/L],NGF[3730.0(598.0)ng/L],S100β[197.2(118.5)ng/L],GFAP[537.4(18
作者
黄怡颖
王文强
李宗磊
HUANG Yiying;WANG Wenqiang;LI Zonglei(Xiamen Xian Yue Hospital, Xiamen 361012,China)
出处
《精神医学杂志》
2021年第6期488-493,共6页
Journal of Psychiatry
基金
国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(编号:2017YFC1309900)。
