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| 血清胰岛素样生长因子1对精神分裂症患者认知功能的预测价值 |
| Analysis of the Predictive Value of Serum IGF-1 for Cognitive Function in Schizophrenia Patients |
| 投稿时间：2024-05-31 |
| DOI：10.3969/j.issn.1000-0399.2025.03.002 |
| 中文关键词: 胰岛素样生长因子-1 精神分裂症 认知功能 预测 |
| 英文关键词: Insulin-like growth factor-1 Schizophrenia Cognitive function Forecast |
| 基金项目:科技创新2030-脑科学与类脑研究重大项目(编号:2021ZD0200600) |
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| 中文摘要: |
| 目的 分析血清胰岛素样生长因子（IGF-1）对精神分裂症患者认知功能的预测价值。方法 回顾性分析合肥市庐江县精神病医院七病区2021年7月至2022年5月收治的151例精神分裂症患者资料，按照MATRIS成套神经认知测试（MCCB）评估结果分为认知功能异常组（MCCB<40分，n=60）和认知功能正常组（MCCB≥40分，n=91）。使用多因素logistic回归分析影响精神分裂症患者认知功能的相关因素；使用Pearson相关分析精神分裂症患者血清IGF-1与MCCB评分、阳性和阴性症状量表（PANSS）评分的相关性以及MCCB评分与PANSS评分的相关性；使用受试者工作特征（ROC）曲线分析血清IGF-1等因子对精神分裂症患者认知功能的预测价值。结果 认知功能异常组血清IGF-1、MCCB评分低于认知功能正常组，其PANSS量表的阳性症状、阴性症状、一般精神病理量表评分和总分均高于认知功能正常组（P<0.05）。调整混杂因素后的logistic回归分析显示，年龄、病程、文化程度初中及以下、复发性精神分裂症和IGF-1均为患者认知功能异常的独立危险因素（P<0.05）。Pearson相关性分析显示，IGF-1与MCCB评分呈正相关（r=0.638,P<0.05），与PANSS总分呈负相关（r=-0.681,P<0.05），精神分裂症患者MCCB评分与PANSS总分呈负相关（r=-0.566,P<0.05）。ROC曲线结果显示，IGF-1预测患者认知功能异常的截断值为65.11 ng/mL，其曲线下面积（AUC）为0.843，灵敏度、特异度分别为83.52%、62.89%;IGF-1联合年龄、病程、文化程度、精神分裂症发病情况预测患者认知功能异常的AUC为0.917，灵敏度、特异度分别为85.37%、90.44%。结论 血清IGF-1水平下降提示精神分裂症患者认知功能损伤，可据此为预测患者认知功能情况提供参考。 |
| 英文摘要: |
| Objective To analyze the predictive value of serum insulin-like growth factor-1 （IGF-1） for cognitive function in schizophrenia patients. Methods The clinical data of 151 schizophrenia patients admitted to our hospital from July 2021 to May 2022 were retrospectively studied.According to the results of their MATRIS neurocognitive test （MCCB） assessment,patients with MCCB＜40 were included in the cognitive dysfunction group （n=60）,and those with MCCB≥40 were included in the cognitive normal group （n=91）.The multivariate logistic regression analysis was used to summarize the influencing factors of cognitive function in schizophrenia patients.The Pearson correlation analysis was used to analyze the correlation between serum IGF-1 and MCCB scores,the positive and negative symptom scale （PANSS） scores of schizophrenia patients,and the correlation between MCCB scores and PANSS scores.The receiver operating characteristic （ROC） curve was used to analyze the area under the curve （AUC）,sensitivity,and specificity of serum IGF-1 and other factors in predicting cognitive function of schizophrenia patients. Results Of the 151 patients,60 had MCCB scores＜40,with a cognitive dysfunction rate of 39.74%.The serum IGF-1 level and MCCB score were lower in the cognitive dysfunction group than in the cognitive normal group,and the positive and negative symptom scores,general psychopathology scale scores,and total scores of the PANSS were higher in the cognitive dysfunction group than in the cognitive normal group （P＜0.05）.The logistic multivariate regression analysis indicated that age＞51 years,disease duration＞1.5 years,junior high school or below education level,recurrent schizophrenia,and IGF-1＜65.11 ng/mL were independent risk factors for cognitive dysfunction in schizophrenia patients （P＜0.05）.The Pearson correlation analysis showed that IGF-1 was positively correlated with MCCB score and negatively correlated with PANSS total score,and the MCCB score was negatively correlated with the PANSS total score （P＜0.05）.The ROC curve showed that the cut-off value of IGF-1 for predicting abnormal cognitive function in patients was 65.11 ng/mL,and its AUC was 0.843,with a sensitivity and specificity of 83.52%and 62.89%,respectively.The AUC of IGF-1 combined with age,duration of illness,literacy,and onset of schizophrenia to predict cognitive abnormalities in patients was 0.917,with a sensitivity and specificity of 85.37%and 90.44%. Conclusion The decline of serum IGF-1 is associated with the progression of cognitive dysfunction in schizophrenia patients,and IGF-1＜65.11ng/mL can provide reliable reference for predicting cognitive dysfunction in patients. |
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