利培酮治疗对急性未服药精神分裂症患者P50的影响  

Effects of risperidone on auditory gating potential P50 in acute medication-free patients with schizophrenia

作　　者：杨贵刚[1,2] 谭云龙[1] 杨甫德[1] 李娟[1] 陈松[1] 张进国[1] 王安文[1] 张荣珍[1] 冯薇[1] 王志仁[1] 张五芳[2] 周东丰[2] 

机构地区：[1]北京回龙观医院,北京100096 [2]北京大学精神卫生研究所,卫生部精神卫生学重点实验室北京大学,北京100191

出　　处：《中国心理卫生杂志》2010年第4期265-269,共5页Chinese Mental Health Journal

基　　金：科技部973计划资助项目(2007CB512307);首都医学发展基金资助项目(2007-3058)

摘　　要：目的:探讨口服利培酮治疗对急性未服药精神分裂症患者听感觉门控P50的影响。方法:共纳入急性未服药精神分裂症患者64例(首发36例,复发28例),采用可变剂量利培酮治疗,分别于治疗前(基线期)及治疗8周后,采用听觉条件(S1)-测试(S2)刺激范式进行P50检测,同时使用阳性和阴性症状量表(the Positive and Negative Syndrome Scale,PANSS)评定患者精神病理症状;选取与患者性别、年龄、受教育年限匹配的健康人90例,测查P50作为正常对照。结果:①首发患者病程明显短于复发患者,但两者P50各指标无统计学差异。②与对照组相比,患者组(首发与复发合为患者组)基线期P50抑制率比值(S2/S1)升高[(36.0±32.0)% vs.(55.5±48.4)%](非正态分布)、S1波幅降低[(3.4±1.6)mV vs.(2.7±1.6)mV]、S1与S2波幅差(S1-S2)减小[(2.2±1.6)ms vs.(1.3±1.3)ms],(P<0.05),其余P50指标差异无统计学意义;③患者组治疗前后的P50各指标无统计学差异(P>0.05);④在基线期患者组P50抑制率(S2/S1)与PANSS阴性量表分呈正相关(r=0.43,P=0.001);治疗8周后此相关性消失。结论:精神分裂症患者听感觉门控缺陷可能是精神分裂症稳定的内表型,与病程具有相对的独立性,利培酮难以改善这种缺陷。Objective： To investigate the effects of risperidone on sensory gating potential P50 in acute medication-free schizophrenics. Methods： Sixty-four acute medication-free schizophrenics （including 36 first-episode and 28 recurrent ones） were recorded of P50 and were evaluated of their psychopathic syndromes with the Positive and Negative Syndrome Scale （ PANSS ） before and after 8 weeks of medication with oral risporidone. And another 90 healthy persons＇PS0 were collected as normal control data. Results： （ 1 ） There was no significant difference of PS0 between the ftrst-episode and recurrent schizophrenics regardless the former had shorter psychiatric course than the later. （2） Comparing with the normal group, the patients （ first-episode and recurrent patients were combined one group wholly ） showed higher P50 suppression ratios （ S2/S1 ） [ （ 36. 0 ± 32. 0） % vs. （ 55.5 ± 48.4） %, P 〈0.05], lowerS1 amplitude[ （3.4±1.6） mVvs. （2.7±1.6） mV] and less amplitude difference （S1-S2）[ （ 2. 2 ± 1.6 ） ms vs. （ 1.3 ±1.3 ） ms] . （ 3 ） There were no significant differences of P50 indices in patients pre- and after risperidone administered. （ 4） There was positive correlation between the patients P50 suppression ratios and the score of Negative Syndrome subscale of PANSS （ r = 0. 43, P = 0. 001 ） . But after 8-week treatment, no correlation was found any more. Conclusion： The results indicate that in schizophrenics there are sensory gating dysfunctions which may be not related to psychiatric course directly, and could not be normalized by medication with risperidone.

关 键 词：精神分裂症 听感觉门控P50 利培酮 精神病理症状 对照研究 

分 类 号：R749.305[医药卫生—神经病学与精神病学]