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目的:探讨双相I型躁狂发作患者血清细胞因子水平及其与认知功能损害的相关性。方法:纳入44例双相I型障碍躁狂发作患者(双相组)和42名人口学资料相匹配的健康志愿者(健康对照组)。采用酶联免疫吸附试验检测外周血清白细胞介素6(interleukin-6，IL-6)、白细胞介素10(IL-10)、白细胞介素23(IL-23)、肿瘤坏死因子-α(tumor necrosis factor-α，TNF-α)水平，使用重复性成套神经心理状态测验(repeatable battery for the assessment of neuropsychological status，RBANS)评定两组的认知功能，杨氏躁狂量表(Young manic rating scale，YMRS)评估患者的临床躁狂症状。采用SPSS 22.0进行假设检验和相关分析。结果:(1)双相组血清细胞因子IL-6、IL-10、IL-23和TNF-α表达水平[分别为(38.872±7.803)pg/ml，(33.259±7.260)pg/ml，42.350(33.600，55.390)pg/ml，(108.309±19.398)pg/ml]与对照组相比[分别为(24.664±6.083)pg/ml，(29.257±5.208)pg/ml，17.360(12.870，30.690)pg/ml，(68.674±13.610)pg/ml]，均差异具有统计学意义(n t＝9.387, n t＝2.947，n Z＝－5.477, n t＝10.921,均n P<0.01)。(2)在RBANS认知测验中，双相组在视觉广度、注意、延时记忆和量表总分中所得的分数[(92.909±16.126)分，(83.091±8.529)分，(80.636±9.592)分，(416.318±33.438)分]与对照组[(82.905±10.958)分，(92.381±14.85)分，(93.714±7.613)分，(436.905±37.228)分]差异均具有统计学意义(n t＝3.378, n t＝－3.538, n t＝－6.982，n t＝－2.700，均n P<0.05)。(3)相关性分析显示，双相组病程与细胞因子IL-6、IL-23水平呈正相关(n r＝0 0.509, n r＝0.298，n P<0.05)；视觉广度得分与IL-10和TNF-α水平呈正相关(n r＝0.426, n r＝0.647，均n P<0.05)；言语与IL-23水平呈负相关(n r＝－0.372，n P<0.05)；注意力得分与IL-6、IL-10和TNF-α呈负相关(n r＝－0.315, n r＝－0.318，n r＝－0.498，均n P<0.05)；延时记忆得分与IL-10和TNF-α呈负相关(n r＝－0.360, n r＝－0.621，均n P0.05)。n 结论:双相I型障碍躁狂发作患者血清细胞因子水平存在变化，部分认知功能受损；患者病程、部分认知功能与血清细胞因子水平改变有一定的相关性。“,”Objective:To explore the relationship between serum cytokine levels and cognitive impairment in patients with bipolar I manic episode.Methods:Forty-four patients with bipolar I manic episode (BDI group) and 42 healthy volunteers (HC group) matched with demographic data were included.Peripheral serum interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-23 (IL-23), and tumor necrosis factor-α (TNF-α) levels were detected by enzyme-linked immunosorbent assay (ELISA). The repeatable battery for the assessment of neuropsychological status (RSPM) was used to evaluate the cognitive function of the two groups.Young manic rating scale (YMRS) was used to evaluate the clinical manic symptoms of patients.Hypothesis testing and correlation analysis were processed by SPSS 22.0.Results:(1) The expression levels of serum cytokines IL-6, IL-10, IL-23 and TNF-α in BDI group ((38.872±7.803), (33.259±7.260), 42.350(33.600, 55.390), (108.309±19.398)) were significantly different with those in HC group ((24.664±6.083), (29.257±5.208), 17.360(12.870, 30.690), (68.674±13.610)), and the differences were statistically significant ((n t=9.387, n t=2.947, n Z=-5.477, n t=10.921, all n P<0.01)). (2) In the RBANS cognitive test, the visual span, attention, delayed memory and total scale scores of the BP group ((92.909±16.126). (83.091±8.529), (80.636±9.592), (416.318±33.438)) were significantly different with those of the HC group ((82.905±10.958), (92.381±14.850), (93.714±7.613), (436.905±37.228),n t=3.378, n t=-3.538, n t=-6.982, n t=-2.700, all n P<0.05). (3)Correlation analysis showed that in the BDI group, the course of disease was positively correlated with IL-6 and IL-23(n r=0.509, n r=0.298, n P<0.05), the visual breadth was positively correlated with IL-10 and TNF-α (n r=0.426, n r=0.647, n P<0.05), language was negatively correlated with IL-23 level (n r=-0.372, n P<0.05), attention was significantly negatively correlated with IL-6, IL-10, and TNF-α (n r=-0.315, n r=-0.318, n r=-0.498, all n P<0.05), delayed memory was positively correlated with IL-10 and TNF-α (n r=-0.360, n r=-0.621, n P0.05).n Conclusion:Patients with bipolar I disorder manic have changes in serum levels of cytokines and cognitive dysfunction. The course of disease and cognitive function are related with serum cytokine level.