| 曹聪,尹航,许雪浩,王风兰,陆秋燕,孙卫珊,王勤,周爱华.稳定期精神分裂症患者血清总胆汁酸水平与认知功能的相关性及其对认知功能受损的预测价值[J].四川精神卫生杂志,2026,(2):133-139.Cao Cong,Yin Hang,Xu Xuehao,Wang Fenglan,Lu Qiuyan,Sun Weishan,Wang Qin,Zhou Aihua,Correlation between serum total bile acid level and cognitive function in patients with stable schizophrenia and its predictive value for cognitive impairment[J].SICHUAN MENTAL HEALTH,2026,(2):133-139 |
| 稳定期精神分裂症患者血清总胆汁酸水平与认知功能的相关性及其对认知功能受损的预测价值 |
| Correlation between serum total bile acid level and cognitive function in patients with stable schizophrenia and its predictive value for cognitive impairment |
| 投稿时间：2025-09-29 |
| DOI：10.11886/scjsws20250929001 |
| 中文关键词: 稳定期精神分裂症 认知功能 胆汁酸 中国简版神经认知成套测验 |
| 英文关键词:Stable schizophrenia Cognitive Total bile acid Chinese Brief Cognitive Test |
| 基金项目:盐城市卫健委医学科研立项项目（项目名称：高频rTMS对缓解期精神分裂患者工作记忆的影响，项目编号：YK2024141） |
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| 中文摘要: |
| 背景 稳定期精神分裂症患者普遍存在持续的认知功能受损。急性期患者血清总胆汁酸（TBA）水平与认知功能受损相关，但稳定期患者血清TBA与多维度认知功能的关系尚不明确。目的 探讨稳定期精神分裂症患者血清TBA水平与认知功能的相关性及其对认知功能受损的预测价值，为及时识别与客观评估认知功能受损提供血清学依据。方法 采用横断面研究，选取2024年3月—12月在盐城市第四人民医院住院的、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）精神分裂症诊断标准的稳定期患者为研究对象（n=137）。采用中国简版神经认知成套测验（C-BCT）评定认知功能，并依据评定结果将患者分为认知正常组（n=28）、轻度受损组（n=28）、中度受损组（n=47）和重度受损组（n=34）。采集患者空腹肘静脉血，使用酶循环法检测血清TBA水平。采用Spearman相关分析考查血清TBA水平与整体及各维度认知功能的关系。采用二元Logistic回归模型（调整年龄、性别、病程等协变量）分析血清TBA水平对整体及各维度认知功能的影响。采用受试者工作特征（ROC）曲线评估血清TBA水平对整体认知功能受损的预测价值。结果 四组患者血清TBA水平比较，差异有统计学意义（H=18.677，P<0.01），中度受损组和重度受损组血清TBA水平均高于认知正常组（调整后P均<0.01）。患者血清TBA水平与整体认知功能分级呈正相关（rs=0.354，P<0.05），与连线测试T分（rs=-0.328，P<0.05）、持续操作T分（rs=-0.247，P<0.05）、数字广度T分（rs=-0.265，P<0.05）和符号编码T分（rs=-0.221，P<0.05）均呈负相关。二元Logistic回归分析显示，血清TBA水平是稳定期精神分裂症患者整体认知受损的独立危险因素（OR=1.322，95% CI：1.021~1.713，P=0.034），尤其对信息处理速度受损具有更强的预测能力（OR=1.325，95% CI：1.057~1.661，P=0.015）。血清TBA预测稳定期精神分裂症患者整体认知功能受损的ROC曲线下面积（AUC）为0.738，灵敏度和特异度分别为60.61%和78.64%。结论 稳定期精神分裂症患者血清TBA水平与整体认知功能分级及信息处理速度、注意力、工作记忆、执行功能相关。血清TBA水平升高是整体认知功能受损和信息处理速度损害的独立影响因素，并对整体认知功能受损具有中等预测价值。 |
| 英文摘要: |
| Background Persistent cognitive impairment is prevalent among patients with stable schizophrenia. While serum total bile acid （TBA） level in acute-phase patients are known to be associated with cognitive dysfunction， the relationship between serum TBA and multi-dimensional cognitive functions in stable phase patients remains unclear.Objective To investigate the correlation between serum TBA level and cognitive function in patients with stable schizophrenia， and to evaluate its predictive value for cognitive impairment， thereby providing a serological biomarker for the timely identification and objective assessment of cognitive dysfunction.Methods A cross-sectional study was conducted on 137 inpatients with stable schizophrenia at The Fourth People's Hospital of Yancheng from March to December 2024. All participants met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Cognitive function was evaluated using the Chinese Brief Cognitive Test （C-BCT）， patients were categorized into four groups： normal cognition （n=28）， mild impairment （n=28）， moderate impairment （n=47）， and severe impairment （n=34）. Fasting venous blood samples were collected， and serum TBA level was quantified using an enzymatic cycle assay. Spearman correlation analysis was ultilized to determine the relationship between serum TBA level， overall cognitive function， and specific cognitive domains. Binary Logistic regression model was used （adjusting for covariates such as age， gender， and disease duration） to analyze the impact of serum TBA level on overall and individual cognitive functions. The predictive value of serum TBA level for overall cognitive impairment was evaluated using receiver operating characteristic （ROC） curve.Results Serum TBA levels differed significantly among the four groups （H=18.677， P<0.01）. Specifically， serum TBA levels in both the moderate and severe cognitive impairment groups were significantly higher than those in the normal cognitive group （adjusted P<0.01）. Serum TBA level was positively correlated with the severity grading of overall cognitive impairment （rs=0.354， P<0.05）， and negatively correlated with T-scores on the trail making test （rs=-0.328， P<0.05）， continuous performance test （rs=-0.247， P<0.05）， digit span （rs=-0.265， P<0.05）， and symbol coding （rs=-0.221， P<0.05）. Binary Logistic regression analysis identified serum TBA level as an independent risk factor for overall cognitive impairment （OR=1.322， 95% CI： 1.021 - 1.713， P=0.034）， with a particularly robust predictive ability for impaired information processing speed （OR=1.325， 95% CI： 1.057 - 1.661， P=0.015）. The area under ROC curve （AUC） for serum TBA level in predicting overall cognitive impairment was 0.738， with a sensitivity of 60.61% and a specificity of 78.64%.Conclusion In patients with stable schizophrenia， elevated serum TBA levels are associated with worse overall cognitive function， as well as deficits in information processing speed， attention， working memory， and executive function. Serum TBA serves as an independent risk factor and exhibits moderate predictive value for overall cognitive impairmen，particularly in the domain of information processing speed. ［Funded by Yancheng Municipal Health Commission Medical Research Project （number， YK2024141）］ |
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