中文摘要：

目的 观察首发精神分裂症患者抗精神病药治疗前后血清中高迁移率族蛋白B1（HMGB1）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1 β）、白细胞介素-6（IL-6）的变化及其相互关系,探索HMGB1在精神分裂症免疫机制中的作用.方法 收集郑州大学第一附属医院2013年1月至2014年12月住院治疗的首发未用药精神分裂症患者30例和30名健康对照者.酶联免疫法（ELISA）测定用药前后血清IL-1β、IL-6、TNF-αHMGB1水平,以阳性和阴性症状量表（PANSS量表）评定患者用药前后的精神症状.结果 （1）首发精神分裂症患者血清HMGB1[（80±13） μg/L]、IL-1β[（51 ±6） ng/L]、IL-6[（44±18） ng/L]、TNF-α水平[（59±10） ng/L]均高于健康对照组[（54±13）μg/L,（25 ±19、17 ±8、41±16） ng/L]（均P＜0.05）;经利培酮治疗后,患者血清中上述因子水平均低于治疗前,且差异均有统计学意义（均P＜0.05）.（2）精神分裂症患者血清HMGB1水平与IL-1β、IL-6、TNF-α水平、PANSS量表阴性症状评分均呈正相关（r=0.377、0.426、0.454、0.558,均P＜0.05）.结论 精神分裂症患者存在免疫激活,HMGB1可能在精神分裂症免疫机制中发挥促炎作用,抗精神病药物治疗后HMGB1水平的下降可能为精神症状改善的一个监测指标。

英文摘要：

Objective To measure serum levels of high mobility group protein B-1 （HMGB1）,interleukin-1β （IL-1β）,interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） before and after antipsychotic treatment,and further study the role of HMGB1 in schizophrenics.Methods Thirty firstepisode schizophrenics who were never treated with neuroleptics from First Affiliated Hospital of Zhengzhou University and thirty healthy subjects were enrolled.Serum levels of cytokines such as HMGB1,IL-1β,IL-6 and TNF-α were examined with enzyme linked immunosorbent assay （ELISA） before and after antipsychotic treatment.Results The serum levels of HMGB1,IL-1β,IL-6 and TNF-α in schizophrenics [（80 zophμ8/L,（51 zo,441 zo,591 zopng/L] were significantly higher than those in the healthy subjects [（54 gni）μ4/L,（25 gni,17 gn,41 gni） ng/L] （P 〈 0.05）.After treating the schizophrenics with the neuroleptic risperidone for 6 months,the serum levels of HMGB1,IL-1 β,TNF-α and IL-6 were decreased.The serum levels of HMGB1 were positively correlated to IL-1β,IL-6,TNF-α and Negative Symptoms （r =0.377,r =0.426,r =0.454,r =0.558,P 〈 0.05）.Conclusions Schizophrenics show activation of the cytokine system and immune disturbance.HMGB1 may play a proinflammatory role in schizophrenia and the decrease of HMGB1 after neuroleptic risperidone treatment may be a marker of mental symptoms remission.