儿童精神分裂症患者微小躯体异常与脑室扩大关系的研究  

Association between minor physical anomalies and ventricular enlargement in childhood schizophrenia

作　　者：郭素芹[1] 苏林雁[2] 杜海霞[1] 郭芳[1] 郭敬华[1] 李强[1] 潘伟盟[1] 

机构地区：[1]新乡医学院第二附属医院儿童少年精神科,453002 [2]中南大学湘雅二医院精神卫生研究所

出　　处：《中华精神科杂志》2007年第4期217-221,共5页Chinese Journal of Psychiatry

基　　金：河南省科技攻关计划项目(Q624410020)

摘　　要：目的探讨儿童精神分裂症患者微小躯体异常(MPAs)与脑室扩大的关系。方法对168例儿童精神分裂症患者(患者组)进行躯体异常量表(WS)评定,并将患者分为 MPAs 明显组(WS总分≥4分,85例)和 MPAs 不明显组(WS 总分≤3分,83例)。用阳性和阴性症状量表(PANSS)评定患者组的精神症状;用 CT 测量患者的脑室(脑室值用哈氏值、三脑室宽度、脑室指数、侧脑室体部指数、侧脑室宽度指数、前角指数表示),并与40名健康儿童(对照组)进行对照。结果(1)患者组哈氏值[(5.37±0.53)cm]和三脑室宽度[(3.83±1.21cm)]均大于对照组[分别为(4.94±0.34)cm和(3.16±0.41)cm],脑室指数(1.55±0.18)和前角指数(3.52±0.31)小于对照组(分别为1.65±0.22和3.77±0.34),均 P<0.01。(2)MPAs 明显组哈氏值[(5.50±0.54)cm]和三脑室宽度[(4.10±1.32)cm]大于 MPAs 不明显组[分别为(5.24±0.49)cm 和(3.55±1.01)cm]和对照组,前角指数(3.47±0.30)小于 MPAs 不明显组(3.57±0.31)和对照组,脑室指数(1.55±0.18)小于对照组。(3)MPAs 不明显组哈氏值大于对照组,脑室指数和前角指数小于对照组,均 P<0.01和 P<0.05。(4)患者组 WS 总分与哈氏值(r=0.263)及三脑室宽度(r=0.287)存在正相关,与前角指数存在负相关(r=-0.178);患者组的 WS 总分与阴性症状分呈正相关(r=0.247);患者组的阴性症状分与哈氏值(r=0.375)和三脑室宽度(r=0.161)呈正相关,与脑室指数(r=-0.159)和前角指数(r=-0.191)呈负相关(均 P<0.01和 P<0.05)。结论儿童精神分裂症患者存在显著的 MPAs 和脑室扩大,MPAs 与脑室扩大之间有明显的相关。Objective The primary purpose of this study was to investigate the association between brain morphological abnormalities and minor physical anomalies （ MPAs ） in childhood schizophrenia. Methods One hundred and sixty-eight children with schizophrenia and 40 healthy children as normal controls were involved in the study. The MPAs were examined with the Waldrop Scale （WS）, and according to the WS score of ≥4 or 〈 4, the children with schizophrenia were divided into subgroups with visible MPAs or inconspicuous MPAs. The brain was scanned with computed tomography （ CT）, and the morphological abnormalities of brain were evaluated with ventricular-brain values, including Huckman＇s value, extend of third ventricle, index of ventricle, index of lateral ventricle body, index of extend of lateral ventricle and index of anterior angle of ventricle. The symptoms were evaluated with the Positive and Negative Syndrome Scale （PANSS）. Results （ 1 ） The patients had significantly higher Huckman＇s value and extend of third ventricle （ t = 4. 870, 3.454 ; P = 0. 000, 0. 001 ） and lower index of ventricle and index of anterior angle （ t = 3. 054, 4. 582 ; P = 0. 003, 0. 000 ） than normal controls. （ 2 ） The schizophrenic children with visible MPAs had significantly higher Huckman＇s value and extend of third ventricle, lower index of anterior angle than ones with inconspicuous MPAs and normal controls. The patients with inconspicuous MPAs had significantly higher Huckman＇s value and lower index of ventricle and index of anterior angle than normal controls. （3） The WS score was significantly positively correlated with Huckman＇s value and extend of third ventricle （ r = 0. 263,0. 287 ; P = 0. 001,0. 000 ） and negatively correlated with index of anterior angle（ r = -0. 178 ,P = 0. 021 ）. The score of negative symptoms was significantly positively correlated with the WS score （ r = 0. 247, P = 0. 001 ） and Huckman＇s value （ r = 0. 375, P = 0. 000） and extend of third ven

关 键 词：精神分裂症 儿童 形态发生 脑室 体层摄影术 X线计算机 微小躯体异常 

分 类 号：R749.3[医药卫生—神经病学与精神病学]