躁狂发作期双相情感障碍患者血清sC5b-9、5-HT和外周血C1q mRNA水平变化对认知功能损害的诊断价值
doi: 10.12259/j.issn.2095-610X.S20250616
Diagnostic Value of Serum sC5b-9，5-HT，and Peripheral Blood C1q mRNA Level Changes on Cognitive Function Impairment in Patients with Bipolar Disorder during Manic Episodes
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摘要:
目的 探究躁狂发作期双相情感障碍患者血清补体激活产物（sC5b-9）、5-羟色胺（5-HT）和外周血C1q mRNA水平变化情况及与认知功能损害间的相关性。 方法 选取2022年1月至2023年12月期间于宝鸡市中心医院就诊的75例躁狂发作期双相情感障碍患者与75例同期健康体检者作为研究对象并分别纳入BD组、健康组，检测研究对象的血清sC5b-9、5-HT、外周血C1q mRNA水平、蒙特利尔认知评估量表（MoCA）并进行对比，根据躁狂发作期BD组患者的MoCA评分进行分组，22～25分纳入认知损伤组（n = 40），≥26分纳入无损伤组（n = 35）并对比血清sC5b-9、5-HT、外周血C1q mRNA水平差异，多元Logistic回归分析双相情感障碍患者认知损伤间的影响因素。 结果 与健康组比较，BD组血清sC5b-9、5-HT及外周血C1qmRNA表达水平明显升高（P < 0.05）；与健康组比较，BD组8项MOCA评分及MOCA总分均明显降低（P < 0.05）；与无损伤组比较，认知损伤组的血清sC5b-9、5-HT及外周血C1qmRNA表达水平明显升高（P < 0.05）；血清sC5b-9、5-HT及外周血C1qmRNA表达水平均是躁狂发作期双相情感障碍患者认知损伤的危险因素（P < 0.05）。 结论 躁狂发作期双相情感障碍患者的血清sC5b-9、5-HT及外周血C1qmRNA表达水平呈异常升高趋势变化，躁狂发作期双相情感障碍患者发生认知功能损害与血清sC5b-9、5-HT及外周血C1qmRNA表达水平密切相关。 Abstract:Objective To investigate the changes in serum complement activation product （sC5b-9）, serotonin （5-HT）, and peripheral blood C1q mRNA levels in patients with bipolar disorder during manic episodes, and their correlation with cognitive impairment. Methods From January 2022 to December 2023, 75 patients with bipolar disorder during manic episodes and 75 healthy individuals who were treated at Baoji Central Hospital were selected and divided into BD group and healthy group. Serum sC5b-9, 5-HT, peripheral blood C1q mRNA levels, and Montreal Cognitive Assessment （MoCA） scores were detected and compared. Patients in the BD group were further grouped based on MoCA scores: cognitive impairment group （22～25 points） （n = 40） and non-impairment group （≥26 points） （n = 35）. Differences in serum sC5b-9, 5-HT, and peripheral blood C1q mRNA levels were compared, and multiple Logistic regression analysis was performed to identify influencing factors of cognitive impairment in bipolar disorder patients. Results Compared to the healthy group, the BD group showed significantly elevated serum sC5b-9, 5-HT, and peripheral blood C1q mRNA expression levels （P < 0.05）. The BD group's 8 MoCA domain scores and total MoCA score were significantly lower than the healthy group （P < 0.05）. Compared to the non-impairment group, the cognitive impairment group demonstrated significantly higher serum sC5b-9, 5-HT, and peripheral blood C1q mRNA expression levels （P < 0.05）. Serum sC5b-9, 5-HT, and peripheral blood C1q mRNA expression levels were risk factors for cognitive impairment in patients with bipolar disorder during manic episodes （P < 0.05）. Conclusion Patients with bipolar disorder during manic episodes show abnormally elevated serum sC5b-9, 5-HT, and peripheral blood C1q mRNA expression levels. Cognitive impairment in these patients is closely related to the expression levels of serum sC5b-9, 5-HT, and peripheral blood C1q mRNA. -
表 1 比较BD组、健康组的血清sC5b-9、5-HT及外周血C1qmRNA表达水平（$\bar x \pm s $）
Table 1. Comparison of the differences in serum sC5b-9，5-HT，and peripheral blood C1q mRNA expression levels between BD group and healthy group（$\bar x \pm s $）
组别 n sC5b-9（μg/L） 5-HT（pg/mL） C1qmRNA BD组 75 565.33 ± 68.23 421.21 ± 28.32 1.41 ± 0.22 健康组 75 324.33 ± 42.44 261.32 ± 21.55 1.12 ± 0.35 t 25.975 38.910 6.075 P <0.001* <0.001* <0.001* *P < 0.05。 
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表 2 比较BD组、健康组的认知功能评分[（$\bar x \pm s $），分]
Table 2. Comparison of cognitive function scores between BD group and healthy group [（$\bar x \pm s $），scores]
组别 n 视空间执行
能力命名 记忆 注意 语言流畅 抽象思维 延迟记忆 定向力 MOCA
总分BD组 75 2.15 ± 1.51 2.10 ± 0.85 4.35 ± 1.53 1.21 ± 0.53 1.15 ± 0.21 0.50 ± 0.25 1.32 ± 0.73 3.23 ± 1.23 13.42 ± 2.43 健康组 75 3.35 ± 1.44 2.54 ± 0.96 5.85 ± 1.64 1.75 ± 0.72 1.47 ± 0.44 0.84 ± 0.36 1.88 ± 0.94 4.55 ± 1.43 21.33 ± 3.54 t −4.981 −2.972 −5.792 −5.231 −5.684 −6.718 −4.075 −6.061 −15.954 P <0.001* 0.003* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* *P < 0.05。
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表 3 比较认知损伤组、无损伤组的基线资料[（$\bar x \pm s $）/n（%）]
Table 3. Comparison of baseline data differences between the cognitive impairment group and the non-impairment group [（$\bar x \pm s $）/n（%）]
组别 n 性别（男） 年龄（岁） 病程（年） 教育水平 高中及以下 大专及以上 认知损伤组 40 20（50.00） 23.42 ± 0.92 1.04 ± 0.29 21（52.50） 19（47.50） 无损伤组 35 15（42.86） 23.29 ± 1.01 1.02 ± 0.25 16（45.71） 19（54.29） t/χ2 2.642 2.348 2.487 3.123 P 0.512 0.527 0.508 0.416
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表 4 比较认知损伤组、无损伤组的血清sC5b-9、5-HT及外周血C1qmRNA表达水平（$\bar x \pm s $）
Table 4. Comparison of the differences in serum sC5b-9，5-HT，and peripheral blood C1q mRNA expression levels between the cognitive impairment group and the non-impairment group（$\bar x \pm s $）
组别 n sC5b-9（μg/L） 5-HT（pg/mL） C1qmRNA 认知损伤组 40 663.32 ± 72.13 487.21 ± 23.43 1.56 ± 0.31 无损伤组 35 278.32 ± 37.34 256.14 ± 18.44 1.09 ± 0.22 t 41.050 67.116 10.708 P <0.001* <0.001* <0.001* *P < 0.05。
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表 5 多元Logistic回归分析躁狂发作期双相情感障碍患者认知功能损害影响因素
Table 5. Multivariate Logistic regression analysis of influencing factors for cognitive impairment in patients with bipolar disorder during manic episodes
因素 B S.E. Wald P OR 95%CI sC5b-9 1.072 0.686 7.255 <0.001* 2.121 1.660～4.737 5-HT 1.317 0.391 7.338 <0.001* 1.513 1.211～3.278 C1qmRNA 2.062 0.705 4.78 0.006* 1.350 1.021～1.713 *P < 0.05。
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