摘要
目的 探讨外周血25-羟维生素D[25(OH)D]、同型半胱氨酸(Hey)在老年精神分裂症(SCH)患者中的表达及其临床意义.方法 选取2021年1月至2023年6月荣军优抚医院就医的140例老人作为研究对象,其中90例老年SCH患者纳入观察组,同期行体检的50例健康老人纳入对照组,比较两组25(OH)D、Hcy水平.将90例老年SCH患者依据性别[男组(49例)、女组(41例)]、年龄[60～70岁组(45例)、＞70岁组(45例)]、病程[A组(＜6个月,27例)、B组(6个月～5年,40例)、C组(＞5年,23例)]、阳性和阴性状态量表(PANSS)评分[D组(71～80分,39例)、M组(81～90分,30例)、H组(＞90分,21例)]分为不同亚组,比较各个亚组患者的25(OH)D、Hcy水平;分析25(OH)D、Hcy与PANSS评分的相关性,另绘制受试者工作特征(ROC)曲线,分析25(OH)D、Hcy及25(OH)D与Hey联合诊断老年SCH的效能.结果 观察组25(OH)D低于对照组,Hey高于对照组;＞70岁组25(OH)D低于60～70岁组,Hey高于60～70岁组;C组25(OH)D低于B组、A组,Hey高于B组、A组;H组25(OH)D低于M组、D组,Hey高于M组、D组,差异有统计学意义(P＜0.05).Pearson相关性分析显示,25(OH)D与PANSS评分呈负相关(r=-0.520,P＜0.05);Hey 与 PANSS 评分呈正相关(r=0.479,P＜0.05).ROC 结果显示,25(OH)D、Hey两者联合诊断老年SCH的曲线下面积(AUC)为0.925、敏感度为98.90％、特异度为92.00％,高于两组单独检测结果.结论 25(OH)D、Hcy在老年SCH患者血清内呈异常表达,两者联合在老年SCH患者的诊断中效果显著,临床应用价值较高.
Abstract
Objective To analyze the expression and clinical significance of 25-hydroxyvitamin D[25(OH)D]and homo-cysteine(Hey)in peripheral blood in elderly patients with schizophrenia(SCH).Methods A total of 140 elderly patients treated in the Veterans Administration Hospital from January 2021 to June 2023 were selected as the study objects,90 el-derly SCH patients were included in the observation group,and 50 healthy elderly patients who underwent physical exami-nation during the same period were included in the control group,the 25(OH)D and Hey levels were compared between the two groups.The 90 elderly SCH patients were analyzed according to gender[male group(49 cases),female group(41 cases)],(age 60-70 years old group[45 cases],＞70 years old group[45 cases]),disease course(group A[＜6 months,27 cases],group B[6 months-5 years,40 cases],group C[＞5 years,23 cases]),positive and negative status scale(PANSS)score(group D[71-80 points,39 cases],group M[81-90 points,30 cases],group H[＞90 points,21 cases])were divided into different subgroups,and the 25(OH)D and Hey levels were compared in each subgroup.The correlation between 25(OH)D,Hey and PANSS score were analyzed,and receiver operating characteristic(ROC)curve was also drawn to analyze the ef-ficacy of 25(OH)D,Hey and 25(OH)D combined with Hey in the diagnosis of elderly SCH.Results The 25(OH)D of ob-servation group was lower than that of control group,and the Hey was higher than that of control group,the 25(OH)D of the 70-year group was lower than that of the 60-70 year group,and the Hey was higher than that of the 60-70 year group,the 25(OH)D of group C was lower than that of group B and group A,and the Hey was higher than that of group B and group A.The 25(OH)D of group H was lower than that of groups M and D,and the Hey was higher than that of groups M and D,the differences were statistically significant(P＜0.05).Pearson correlation showed that 25(OH)D was negatively correlated with PANSS score(r=0.520,P＜0.05);Hcy was positively correlated with PANSS score(r=0.479,P＜0.05).ROC results showed that the area under the curve(AUC),sensitivity and specificity of 25(OH)D and Hcy combined in the diagnosis of SCH in the elderly were 0.925,98.90％and 92.00％,which were higher than the results of 25(OH)D and Hcy alone.Con-clusion 25(OH)D and Hcy are abnormally expressed in the serum of elderly SCH patients,and the combination of the two has significant effect in the diagnosis of elderly SCH patients,and has high clinical application value.
维普
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