微小躯体异常与儿童精神分裂症的关系  

Minor Physical Anomalies in Childhood Schizophrenia

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

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

出　　处：《中国神经精神疾病杂志》2008年第6期354-358,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：河南省科技攻关项目(编号:0624410020)

摘　　要：目的探讨微小躯体异常(MPA)与儿童精神分裂症的关系。方法纳入168例年龄≤16岁的符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)精神分裂症诊断标准的患者和170名健康儿童对照,采用Waldrop编制的躯体异常量表(WS)修改版评定2组的MPA发生情况。用Andreason阳性与阴性精神分裂症分型标准将患者分为阴性症状为主型(阴性组)和阳性症状为主型(阳性组)进行亚组间比较。结果①患者组和对照组MPA检出率分别为98.8%和70.6%,差异有统计学意义(μ=5.53,P<0.01)。患者组头颅畸形、眉毛融合、眦距过宽、面部不称、畸形耳、耳座位置过低、腭弓高而窄、第五指弯曲、通关掌检出率均较对照组高,差异有统计学意义(OR为1.97～5.33,P均小于0.05);logistic回归模型分析中此9个条目进入方程,提示其与儿童精神分裂症有关;判别分析显示这9个条目可作为预测变量,总判别正确率为76.0%,而患者组和对照组的判别正确率分别为74.4%和77.6%。②患者组头、眼、耳、口、手、足各WS分量表评分及总分均显著高于对照组(P<0.05);③阴性组患者头、口、手各WS分量表评分及总分均显著高于阳性组(P<0.05)。结论MPA与儿童精神分裂症或至少与其某一亚型存在关联,提示精神分裂症可能与神经发育异常有关。Objective The aim of this study was to assess the frequency and type of minor physical anomalies in childhood schizophrenic patients, and compare the difference on minor physical anomalies between negative and positive childhood schizophrenia. Methods One hundred sixty eight childhood schizophrenia and 170 normal subjects were examined for minor physical anomalies using the Waldrop scale （WS）. The patients were assigned into negative and positive schizophrenia based on definition and validation criterion of negative and positive schizophrenia. Results （1）The frequency of minor physical anomalies including abnormal head circumference, fused eyebrows, telecanthus, facial asymmetry, malformed ears, low-seated ears, high/steepled palate, curved fifth finger, abnormal palmar crease was two to five folds higher in childhood schizophrenia than in normal controls. The results of multivariable logistic regression analysis showed that odds ratios were from 1.97 to 5.33. （2）Childhood schizophrenia had significantly higher WS scores than normal subjects in the global head, eye, ear, mouth, hand and the total anomalies scores （P 〈 0. 01 ）. （3）Negative patients had significantly higher WS scores than positive patients in the global head, mouth, hand and the total anomalies scores（P 〈0. 05）. （4）. The two-group discriminate analysis distinguished well the childhood schizophrenic patients from the controls with 9 predictive variables. The variables with significant contribution to prediction of the patient-control status were abnormal head circumference, fused eyebrows, telecanthus, facial asymmetry, malformed ears, high/steepled palate, curved fifth finger （P 〈 0. 001 ） , low-seated ears and abnormal palmar crease （P 〈 0. 01 ）. The model overall correct classification was 76. 0% and classification was better in the controls than in the schizophrenia （77.6% vs. 74. 4% ）. Conclusions Childhood schizophrenia has significantly higher rate and values for minor physical anomalies, especi

关 键 词：精神分裂症 儿童 微小躯体异常 

分 类 号：R749.3[医药卫生—神经病学与精神病学]