急性躁期患者細胞免疫功能之活化__臺灣人文及社會科學引文索引資料庫

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題名：	急性躁期患者細胞免疫功能之活化
書刊名：	臺灣精神醫學
作者：	蔡尚穎／陳坤波／楊沂淵／陳喬琪／李儒卿／呂思潔
作者(外文)：	Tsai, Shang-ying／Chen, Kun-po／Yang, Yi-yuan／Chen, Chiao-chicy／Lee, Ju-chin／Leu, Sy-jye C.
出版日期：	1998
卷期：	12:3
頁次：	頁35-45
主題關鍵詞：	雙極型情感疾患；急性躁期；細胞免疫力；細胞激素-受體；Bipolar disorder；Manic episode；Cell-mediated immunity；Cytokine-receptor
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:0 共同引用:4 點閱:41

　　　　　目的:目前有關躁症的免疫變化研究不多且結果不一致,由於細胞激素以及其受體在體內的變化可能與精神病患其精神－生理反應有關，而國內尚無相關之研究報告，故本研究乃就急性躁期前後之免疫力及細胞激素受體的變化加以研究。方法：選擇男、女各5位確定診斷為雙極性情感疾患（躁鬱症）之急性躁期病患，年齡低於40歲、楊氏躁症量表得分高於30、無物質濫用且無生理疾病者為研究對象。取得血液樣本後，以不同的mitogen刺激淋巴細胞，再測定淋巴細胞之增殖指數(proliferation index)，並測定血清中介白質素-2受體 (soluble interleukin-2 receptor ,sIL-2R)與slL-6R的濃度。個案於急性躁期緩解至楊氏躁症量表得分低於12，再進行第二次的免疫力測定，兩次結果再與經性別、年齡為條件挑選的健康對照組進行比較。結果:個案平均32.1歲，兩次抽血的間隔為39.1±9.3天；PHA（刺激T淋巴細胞）(p<0.01)與PWM（刺激T與B淋巴細胞）(p<0.05)之增殖指數，於躁期均有明顯高於緩解期：slL-2R於躁期血清濃度明顯高於緩解期(p<0.05)，slL-6R則無變化；緩解期則均無異於健康對照組。結論：本研究發現躁鬱症病患在急性躁期之細胞免疫力 (cell-mediated immunity)有明顯的活化現象，躁期症狀之嚴重度與免疫功能之改變有關；急性躁期僅sIL-2R而無slL-6R升高，此現象不同於精神分裂症與憂鬱症其slL-2R以及slL-6R均升高，顯示躁鬱症之精神－生理機轉可能不同於其他的精神病。

以文找文

　　　　　Object:A number of studies have assessed the status of immune systems in psychiatric disorders, especially the status of cell-mediated immunity (CMI)and cytokines. However, most of these studies have focused on schizophrenia and depressive disorders. In particular, there are few reports concerning immune status in bipolar manic patients. Furthermore, reports on immune status in bipolar manic patients have been conflicting. This study sought to control those factors responsible for the conflicting findings in previous studies and thereby provide a clear picture of the impact of mania on immune function. Methods: Acute inpatients with a diagnosis of bipolar disorder, mania (DSM-III-R) with ≦40 years of age, Young's Mania Rating Scale(YMRS) ≧30, who were free from acute or chronic infectious disease were recruited for study (N=10;5 males and 5 females with mean age 32.1 years). A blood sample was withdrawn between 7 a.m. and 9 a.m. on the next morning. Follow-up blood samples were collected from the subject when the manic episode subsided (YMRS≦12). To minimize the potential effects of psychotropic medications on immunity, all subjects were treated with lithium, haloperidol, and bezodiazepines after admission. Age-and sex-matched healthy volunteers (n=10) were selected as controls. The following immune variables were measured:(1)lymphocyte proliferation responses to various mitogens, including phytohaemagglutinin (PHA), concanavalin A (Con A), and pokeweed mitogen (PWM); (2) the plasma concentration of sIL-2R and sIL-6R. Results: The mean duration from the initial to the follow-up blood collection was 39.1±9.3days. There was a significantly higher level of sIL-2R and activation of lymphocyte mitogenesis during manic episodes. Furthermore, the concentration of sIL-2R was significantly higher (p<0.05)in manic subjects than controls. No significant difference in lymphocyte proliferation was found between manic patients after remission and healthy controls. Conclusions: This study found that an activation of CMI with increased levels of sIL-2R but not sIL-6R may be indicative of immune response in a manic episode. These findings suggest that the manifestation of immunity in mania differs from that in schizophrenia and major depression, in which levels of both sIL-2R and sIL-6R are elevated.(Full Text in Chinese)

以文找文

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圖書
1.	American Psychiatric Association(1987)。American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders。Washington, DC：American Psychiatric Association。

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