事件相关电位与初发和复发精神分裂症临床症状的关系

发布时间：2018-08-28 07:22

【摘要】：目的研究初发精神分裂症(FSZ)和复发精神分裂症(RSZ)患者事件相关电位变异与临床症状的关系,探讨变异性质及相关机制。方法应用Bravo脑电生理仪及听觉靶-非靶刺激序列技术对96例FSZ、118例RSZ及110名健康成人进行P3检测,并用阳性和阴性症状量表(PANSS)评定患者精神症状。病例组于治疗6周时进行P3随访。结果在Cz脑区中,FSZ和RSZ患者P3潜伏期延迟及波幅降低与阳性症状分和PANSS总分呈负相关。3组在靶潜伏期N2、P3及非靶P2,波幅P3和非靶波幅P2上的差异有统计学意义(P0.05或P0.01)。与正常对照组相比,FSZ和RSZ潜伏期N2和P3延迟,P3波幅降低(P0.05或P0.01)。与FSZ相比,RSZ非靶P2延迟,非靶P2波幅下降(P0.05)。治疗后P3中靶波幅P3的恢复仅见于FSZ患者,不见于RSZ患者。RSZ患者P3的P3波幅,在治疗干预后明显恢复不良。对FSZ和RSZ患者的随访结果显示:P3中潜伏期N2和P3延迟可能属于该疾病的属性标志;而靶波幅P2和P3下降可能属于该疾病的状态标志。结论本病在发病初期存在认知功能缺陷,这种认知缺陷可能对患者今后的发病、治疗效果和社会功能会产生影响。随访结果提示本病P3变化是混合性标志。
[Abstract]:Objective to study the relationship between event-related potential variation and clinical symptoms in patients with (FSZ) and recurrent schizophrenia (RSZ), and to explore the nature and mechanism of variation. Methods the P3 of 96 FSZ,118 patients with RSZ and 110 healthy adults was detected by Bravo electrophysiologic instrument and auditory target-non-target stimulation sequence. The positive and negative symptom scale (PANSS) was used to evaluate the mental symptoms of the patients. The patient group was followed up at 6 weeks after treatment. Results the latency and amplitude of P3 in patients with Cz and RSZ were negatively correlated with the scores of positive symptoms and the total score of PANSS. 3 groups had significant difference in target latency, non-target P2, amplitude P3 and non-target P 2 (P0.05 or P0.01). Compared with the normal control group, the amplitude of N2 and P3 delayed P3 in the latency of FSZ and RSZ decreased (P0.05 or P0.01). Compared with FSZ, non-target P2 delayed and non-target P2 amplitude decreased (P0.05). After treatment, the recovery of target amplitude P3 was found only in patients with FSZ, but not in patients with RSZ. The follow-up results of FSZ and RSZ patients showed that the latency N2 and P3 delay in the middle stage of 1: P3 might belong to the attribute marker of the disease, while the decrease of the target amplitude P2 and P3 might be the state markers of the disease. Conclusion there are cognitive deficits in the early stage of the disease, which may have an impact on the future onset, therapeutic effect and social function of the patients. The results of follow-up indicated that the change of P3 was a mixed marker.
【作者单位】：上海交通大学医学院附属精神卫生中心精神科;上海交通大学医学院附属精神卫生中心神经生理室;同济大学附属同济医院精神科;复旦大学附属华山医院精神科;上海市闸北区精神卫生中心精神科;
【基金】：上海申康医院发展中心新兴前沿技术项目(SHDC12013116) 申康市级医院适宜技术联合开发推广应用项目(SHDC12012234) 上海卫生系统适宜技术推广计划(2013SY069)~~
【分类号】：R749.3

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