摘要
目的探讨血浆miR-137表达水平对奥氮平治疗精神分裂症(SZ)疗效的预测价值。方法选取杭州市第七人民医院2021年6月至2022年12月收治的SZ患者78例,均予奥氮平单药治疗4周。采用阳性与阴性症状量表(PANSS)评估临床疗效,qRT-PCR法测定治疗前后血浆miR-137表达水平。采用Pearson相关分析治疗4周后血浆miR-137表达水平与PANSS评分的相关性,ROC曲线分析血浆miR-137表达水平对奥氮平治疗SZ疗效的预测效能。结果78例SZ患者奥氮平治疗后PANSS总分及阳性症状、阴性症状、一般精神病理症状评分均明显低于治疗前(均P<0.05)。奥氮平治疗无效(PANSS减分率<50%)30例,有效(PANSS减分率≥50%)48例。有效组患者治疗后血浆miR-137表达水平较治疗前明显降低(P<0.05),而无效组患者治疗前后血浆miR-137表达水平比较差异无统计学意义(P>0.05)。奥氮平治疗4周后血浆miR-137表达水平下降差值与PANSS总分、阳性症状评分及一般精神病理症状评分的减分值均呈正相关(r=0.495、0.493、0.373,均P<0.05)。血浆miR-137表达水平下降差值预测奥氮平治疗SZ疗效的AUC为0.875(95%CI:0.801~0.949),灵敏度为0.750,特异度为0.933,截断值为0.332。结论血浆miR-137表达水平能在一定程度上预测奥氮平治疗SZ的临床疗效。
Objective To investigate the predictive value of plasma miR-137 expression for the efficacy of olanzapine in the treatment of schizophrenia(SZ).Methods A total of 78 SZ patients admitted to Hangzhou Seventh People's Hospital from June 2021 to December 2022 were selected and all of them were treated with olanzapine monotherapy for 4 weeks.The positive and negative symptom scale(PANSS)was used to evaluate the clinical efficacy,and the plasma miR-137 expression level was determined by qRT-PCR before and after treatment.Pearson correlation analysis was used to analyze the correlation between plasma miR-137 expression level and PANSS score after 4 weeks of treatment,and ROC curve was used to analyze the predictive performance of plasma miR-137 expression level in the efficacy of olanzapine on SZ.Results The PANSS total score and the sub-scale scores for positive symptom,negative symptom and general psychopathology symptom of 78 SZ patients after olanzapine treatment were all significantly lower than those before treatment(all P<0.05).There were 30 patients in the ineffective group(PANSS reduction rate<50%)and 48 patients in the effective group(PANSS reduction rate≥50%).The plasma miR-137 expression level of patients in the effective group decreased significantly after treatment compared to that before treatment(P<0.05),while there was no statistically significant difference in the plasma miR-137 expression level of patients in the ineffective group before and after treatment(P>0.05).After 4 weeks of olanzapine treatment,the down-regulation of plasma miR-137 expression level was positively correlated with the reduction of PANSS total score,positive symptom score,and general psychopathology score(r=0.495,0.493,0.373,all P<0.05).The down-regulation of plasma miR-137 expression level predicted the efficacy of olanzapine in the treatment of SZ with the AUC of 0.875(95%CI:0.801-0.949),sensitivity of 0.750,specificity of 0.933,and cutoff value of 0.332.Conclusion The expression level of plasma miR-137 can predict the clinical efficacy of olanzapine in the treatment of SZ to some extent.
作者
闫盼
刘晓妍
张腾
王姝琪
王晟东
宋明芬
YAN Pan;LIU Xiaoyan;ZHANG Teng;WANG Shuqi;WANG Shengdong;SONG Mingfen(Department of Molecular Biology Laboratory,Hangzhou Seventh People's Hospital(the Affiliated Mental Health Center,Zhejiang University School of Medicine),Hangzhou 310013,China;不详)
出处
《浙江医学》
CAS
2023年第15期1631-1634,1646,共5页
Zhejiang Medical Journal
基金
浙江省基础公益研究计划项目(LGF22H090014)
浙江省医药卫生科技计划项目(2020KY222)。
