儿童期性虐待受害者记忆、执行功能与血浆神经肽Y的关系  

Plasma neuropeptide-Y and cognitive function in female inmates with childhood sexual abuse

作　　者：黄国平[1] 张亚林[1] 邹韶红[1] 申景进[1] 向慧[1] 赵兰 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011 [2]湖南新路职业学校

出　　处：《中华精神科杂志》2006年第1期12-15,共4页Chinese Journal of Psychiatry

摘　　要：目的探讨儿童期性虐待(CSA)受害者认知障碍的生化机制。方法对某职业学校成人服刑女犯21例CSA受害者(CSA组)和21例同校服刑女犯(对照组)进行威斯康星卡片分类测验(WCST)和韦氏记忆测验,用放射免疫方法检测血浆神经肽Y(NPY)水平,并分析NPY与认知功能、创伤后应激症状(IES-R)的关系。结果(1)CSA组的IES-R总分及闯入因子、麻木/回避因子和高警觉因子3个因子分均高于对照组(P<0·01);(2)CSA组在顺数、倒数、积累、图片、再生、联想、触摸、长时记忆、短时记忆、记忆商数等的评分均低于对照组,而总试验次数和随机错误数则多于对照组(P<0·01和P<0·05);(3)CSA组血浆NPY水平[(73±56)NG/L]低于对照组[(134±53)NG/L;P=0·001];(4)NPY水平与记忆商数(R=0·354)、短时记忆(R=0·385)、再生(R=0·340)、触摸(R=0·328)呈正相关(P<0·05和P<0·01),与WCST各测验分数和IES-R总分无相关(P>0·05)。结论儿童期性虐待受害者的执行功能和记忆明显受损,血浆NPY水平下降可能是其记忆损害的生化机制之一,而创伤后应激症状与血浆NPY水平下降无关。Objective To explore the cognitive functions among female victims with childhood sexual abuse （CSA） and its relationship to the plasma neuropeptide-Y （NPY）. Methods Twenty-one victims with CSA and 21 age- and education-matched controls were screened out in female inmates. The Wechaler Memory Scale （WMS）, Wisconsin Card Sorting Test （WCST） and the Impact of Event ScaleRevised （IES-R） were administered to them. The plasma NPY was determined with immunoradiometric assay. Bivariate spearman correlations between NPY and cognitive function and IES-R were analyzed. Results The scores of WMS memory quotient （MQ） （85.09 ± 19. 15）, long-term （25.90± 7.36） and short-term （55.55± 11.34） memory in CSA group were significantly lower than that in control group （ 105.57 ± 14. 65, P =0. 000; 34. 47±4.72, P =0. 000; 65.01 ±7.25, P =0. 001, respectively）. The scores of WCST total trials （92.21±24. 40） and random errors （44. 79±21.55） in CSA group were significantly higher than that in controls （ 67. 90 ± 19. 64, P= 0. 001 ; 22. 33 ± 14.61, P = 0. 000, respectively）. Plasma NPY level in CSA group was significantly lower than that in controls [ （73 ±56）ng/L vs. （ 134± 53） ng/L; P = 0. 001 ]. The NPY level was significantly positively correlated with the MQ （ r= 0. 354, P 〈 0. 05）, short-term memory （r = 0. 385, P 〈 0. 05）, but not related to the WCST parameters or IES-R total score. Conclusion The results indicate the female victim with childhood sexual abuse has memory and execution impairments. The decreased plasma NPY level may play a role in the memory impairment, but not related to the severity of posttraumatic stress symptoms.

关 键 词：猥亵儿童 应激障碍 创伤后 认知障碍 

分 类 号：R749.94[医药卫生—神经病学与精神病学]