非急性期病情基本稳定精神分裂症患者认知功能、P300和脑灰质体积的相关研究

发布时间：2018-04-08 12:45

本文选题：精神分裂症　切入点：认知功能障碍　出处：《昆明医科大学》2012年硕士论文

【摘要】：目的1.研究既往使用过抗精神病药物疗效不满意但病情基本稳定(非急性期)的精神分裂症患者(以下简称精神分裂症患者)认知功能损害特点；2.研究认知功能与精神症状、社会功能的相关性；3.研究精神分裂症患者脑灰质体积的变化及其与P300相关性。方法1.随机选取18例既往使用过抗精神病药物疗效不满意但病情基本稳定的非急性期精神分裂症患者,采用听觉事件诱发电位(P300)、神经认知心理成套测验(MCCB)和附加测验检测患者与18名正常对照者的认知功能,采用阳性与阴性症状量表(PANSS)和临床总体印象量表(CGI-S)评定患者的精神症状,使用个人与社会功能量表(PSP)评定患者的社会功能,采用锥体外系副反应量表(SAS)、不自主运动量表(AIMS)和静坐不能量表(BARS)评定既往使用抗精神病药物副反应情况。2.分别使用磁共振和脑诱发电位仪,对患者和对照者进行脑部影像学和神经电生理检查,获得脑部磁共振三维(3D)图像和P300的数据,研究P300相关脑灰质区域。结果1.非急性期病情基本稳定精神分裂症患者的神经心理测试成绩与对照组比较有统计学意义(P0.05),包括：连线测验、符号编码、空间广度、迷宫、范畴流畅性测验、情绪管理、持续操作相同配对(CPT):2-D、3-D、4-D,沟槽钉板：利手和非利手、空间广度记忆、颜色连线1试及2试、范畴流利性测验、Stroop颜色词的干扰测试：单词、颜色和色词、听觉连续加法。2.非急性期病情基本稳定精神分裂症患者的P300潜伏期和对照组比较,潜伏期(P0.05)缩短,波幅没统计学差异。3.患者社会功能与连线测验A部分、颜色连线测验2和威斯康辛卡片总错误数负相关(-1r0),患者社会功能和范畴流利测验、威斯康辛卡片总正确数及分类个数成正相关(1r0),P300波幅和威斯康辛卡片分类个数成正相关(1r0),潜伏期可能和非持续错误数成正相关(r值=0.430,P=0.052)。4.患者的神经心理测验、P300与精神症状和锥体外系无相关性。5.患者的P300潜伏期与部分脑灰质体积(右颞叶的颞上回和颞中回、右后叶小脑扁桃体、右侧小脑后叶、下半小叶)相关。结论1.非急性期精神分裂症患者的认知功能存在广泛的损害,可能是其对抗精神病药物疗效欠佳的原因之一。2.患者的认知功能与社会功能相关,其认知功能障碍可能显著影响患者的社会功能。3.患者的认知功能和精神症状、锥体外系反应无相关性,提示认知功能障碍可能是精神分裂症的一个独立的特征性病变。4.患者的额叶、颞叶和小脑部分区域的灰质体积与对照组有差异,且患者的P300潜伏期和右颞叶的颞上回和颞中回、右侧小脑后叶、下半小叶和右后叶小脑扁桃体的灰质相关,这些区域有可能是患者P300异常的脑结构基础,提示患者认知功能障碍有其相应的病理生理过程和脑器质病变基础。
[Abstract]:Objective 1 . To study the cognitive impairment characteristics of patients with schizophrenia ( hereinafter referred to as schizophrenia ) who were not satisfied with the efficacy of anti - psychotic drugs but were basically stable ( non - acute stage ) .
2 . To study the correlation between cognitive function and mental symptoms and social function ;
3 . To study the changes of brain gray matter volume in schizophrenic patients and the correlation between them .

Methods 1 . The cognitive function of 18 patients with non - acute schizophrenia who had not satisfied the efficacy of anti - psychotic drugs was randomly selected . The cognitive function of the patients was assessed by auditory event evoked potential ( P 300 ) , neurocognitive psychological test ( MCCB ) and additional test ( CGI - S ) . The patients and controls were assessed by using the positive and negative symptoms scale ( PANSS ) and the clinical general impression scale ( CGI - S ) .

Results 1 . The neuropsychological test scores of patients with basic stable schizophrenia in non - acute stage were statistically significant ( P0.05 ) , including : connection test , sign coding , spatial breadth , maze , category fluency test , mood management , continuous operation same pairing ( CPT ) : 2 - D , 3 - D , 4 - D , groove nail plate : Lishi and non - profit hand , spatial breadth memory , color connection 1 test and 2 - test , categorical fluency test , Stroop color word interference test : word , color and color words , auditory continuous addition .

Conclusion 1 . The cognitive function of patients with non - acute schizophrenia has extensive damage , which may be one of the causes of the poor curative effect of psychoses . 2 . The cognitive function of the patients is related to the social function . The cognitive impairment may be a distinct characteristic lesion of schizophrenia .

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.3

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