精神分裂症患者一级亲属及首发患者认知功能的对照研究
发布时间：2018-10-11 09:13
【摘要】：背景精神分裂症是一组病因不明确的常见重性精神病,关于精神分裂症的发病因素和机制,目前存在争论,但在家族遗传、分子遗传等方面的研究均发现该类疾病有显著的遗传特征,遗传因素在精神分裂症发病中如何发挥作用,也尚无定论;精神分裂症患者认知功能的损害造成其社会功能的恢复困难也是目前临床治疗过程中瓶颈问题;深入探讨精神分裂症患者的认知损害特点,综合各种治疗方法帮助该类疾病患者恢复认知具有十分重要的现实意义。目的1.首发精神分裂症患者、精神分裂症患者的一级亲属、正常对照组间认知功能的差异;2.首发精神分裂症患者在有无精神病家族史方面认知功能的差异;3.首发精神分裂症患者在应用非典型抗精神病药物治疗前后认知功能的差异,本研究首发组均使用利培酮治疗,通过上述研究,以期寻找出患者及其家族成员遗传异质性的内在特点,从而对于该病的发生提前做一些有效的干预工作。方法将首发精神分裂症患者、精神分裂症患者的一级亲属、健康志愿者分别选取60名入组,即首发患者组、一级亲属组和正常组,症状评定由10名精神科主治医师完成,他们全部经过统一的标准化培训;认知功能评定工具采用精神分裂症认知疗效评定的测量工具—精神分裂症认知功能成套测验-共识版(MCCB),包括连线测试、Stroop色词测验在内共六项,由2名专业培训的精神科副主任医师完成,患者组在治疗前后需要评定阳性、阴性精神症状,采用PANSS评分,最后应用SPSS 24.00进行数据处理。结果1首发精神分裂症患者的各项MCCB神经心理测验成绩与正常对照组均有显著差异,P均㩳0.01,具有统计意义;精神分裂症一级亲属组的连线测试、符号编码、HVLT-R、Stroop色词测验的颜色、色词成绩与对照组有显著差异,P均㩳0.01,具有统计意义,Stroop色词测验的单词成绩、持续操作测验(CPT)各项结果与对照组比较有差异,P均㩳0.05,具有统计学意义,其他MCCB结果与正常对照组比较,无统计意义。2有阳性家族史的首发组与无阳性家族史的首发组的符号编码、HVLT-R(总分、T3)、CPT-IP(总分、2D)、Stroop色词测验单词成绩比较差异较明显,P均㩳0.01,表示两组样本之间具有有显著的差异。3首发精神分裂症患者在治疗前后的神经心理测验结果比较除HVLT-R总分、TI、T2、T3、BVMT-R(T1)无差异外,P㧐0.05,其余各项如连线测试、Stroop色词测验等其余各项指标均显著差异,P㩳0.01,有统计学意义;治疗前后首发组PANSS评分中阳性症状、阴性症状及一般病理对照差异显著,P㩳0.01,均有统计意义。结论1.认知功能损害普遍出现在首发精神分裂症患者当中。2.精神分裂症患者的一级亲属已经出现处理速度与注意警觉、言语记忆等方面认知功能损害。3.有阳性家族史的首发精神分裂症患者在注意警觉、词语学习记忆、工作记忆等方面存在显著的缺陷。4.首发精神分裂症患者经过药物治疗后认知功能可得到改善,处理速度、工作记忆、注意警觉恢复的比较显著。
[Abstract]:Background schizophrenia is a group of common serious psychoses with unclear etiology, and there is an argument about the pathogenesis and mechanism of schizophrenia, but studies on family heredity, molecular genetics and so on have found that these diseases have significant genetic characteristics. The genetic factors play a role in the pathogenesis of schizophrenia, and there is no definite conclusion; the impairment of cognitive function in the patients with schizophrenia is the bottleneck problem in the current clinical treatment process; the cognitive impairment characteristics of the patients with schizophrenia are discussed in detail. It is of great practical significance to synthesize various treatment methods to help patients with these diseases recover their cognition. Purpose 1. The difference of cognitive function among patients with first-episode schizophrenia, first-degree relatives of schizophrenia and normal control group; 2. Differences in cognitive function in patients with first-episode schizophrenia in the absence of family history of mental illness; 3. The difference of cognitive function before and after the treatment of atypical antipsychotics was used in the first episode of schizophrenia, and the first group was treated with Lepione, with a view to finding the intrinsic characteristics of genetic heterogeneity among patients and their families. so as to do some effective interventions for the occurrence of the disease. Methods Sixty patients with schizophrenia, first-order relatives and healthy volunteers were selected from 60 enrolled patients, namely, the first group, the first-level relatives group and the normal group. The cognitive function assessment tool used the cognitive function complete test-consensus version (MCCB) of the schizophrenia cognitive function evaluation tool, including the connection test, the pop-up color word test, six in total, and the two professional trained psychiatrist completed the test. The patient group needs to evaluate the positive and negative mental symptoms before and after treatment, the PANSS score is adopted, and the data processing is finally carried out by SPSS 24.00. Results There were significant differences between the MCCB neuropsychological test scores and the normal control group in the first episode of schizophrenia. 0. 01, with statistical significance; connection test, symbol coding, HVLT-R, Sop color word test of relatives group at the first level of schizophrenia, with significant difference in color word score and control group, all P? 0. 01, with statistical significance, the results of continuous operation test (CPT) were different from those in the control group, all of which were different from those in the control group. 0. 05, with statistical significance, the results of other MCCB were not statistically significant compared with the normal control group. There was no statistical significance. There was a significant difference between the first group of positive family history and the initial group without positive family history, HVLT-R (total score, T3), CPT-IP (total score, 2D). P鍧，
本文编号：2263649
[Abstract]:Background schizophrenia is a group of common serious psychoses with unclear etiology, and there is an argument about the pathogenesis and mechanism of schizophrenia, but studies on family heredity, molecular genetics and so on have found that these diseases have significant genetic characteristics. The genetic factors play a role in the pathogenesis of schizophrenia, and there is no definite conclusion; the impairment of cognitive function in the patients with schizophrenia is the bottleneck problem in the current clinical treatment process; the cognitive impairment characteristics of the patients with schizophrenia are discussed in detail. It is of great practical significance to synthesize various treatment methods to help patients with these diseases recover their cognition. Purpose 1. The difference of cognitive function among patients with first-episode schizophrenia, first-degree relatives of schizophrenia and normal control group; 2. Differences in cognitive function in patients with first-episode schizophrenia in the absence of family history of mental illness; 3. The difference of cognitive function before and after the treatment of atypical antipsychotics was used in the first episode of schizophrenia, and the first group was treated with Lepione, with a view to finding the intrinsic characteristics of genetic heterogeneity among patients and their families. so as to do some effective interventions for the occurrence of the disease. Methods Sixty patients with schizophrenia, first-order relatives and healthy volunteers were selected from 60 enrolled patients, namely, the first group, the first-level relatives group and the normal group. The cognitive function assessment tool used the cognitive function complete test-consensus version (MCCB) of the schizophrenia cognitive function evaluation tool, including the connection test, the pop-up color word test, six in total, and the two professional trained psychiatrist completed the test. The patient group needs to evaluate the positive and negative mental symptoms before and after treatment, the PANSS score is adopted, and the data processing is finally carried out by SPSS 24.00. Results There were significant differences between the MCCB neuropsychological test scores and the normal control group in the first episode of schizophrenia. 0. 01, with statistical significance; connection test, symbol coding, HVLT-R, Sop color word test of relatives group at the first level of schizophrenia, with significant difference in color word score and control group, all P? 0. 01, with statistical significance, the results of continuous operation test (CPT) were different from those in the control group, all of which were different from those in the control group. 0. 05, with statistical significance, the results of other MCCB were not statistically significant compared with the normal control group. There was no statistical significance. There was a significant difference between the first group of positive family history and the initial group without positive family history, HVLT-R (total score, T3), CPT-IP (total score, 2D). P鍧，
本文编号：2263649
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