慢性精神分裂症男性患者听觉刺激惊跳反射的初步研究  

A preliminary study of acoustic startle reflex in male patients with chronic schizophrenia

作　　者：王志仁[1] 谭云龙[1] 杨甫德[1] 张五芳[2] 邹义壮[1] 宋崇生[1] 周宇[1] 李英丽[1] 张向阳[1] 周东丰[2] 

机构地区：[1]北京回龙观医院精神医学研究中心,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

出　　处：《中华精神科杂志》2010年第3期135-139,共5页Chinese Journal of Psychiatry

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）;北京市科委重大课题资助项目（D0906001040191）

摘　　要：目的 探讨汉族人群精神分裂症患者是否存在听觉惊跳反射缺陷及抗精神病药的影响.方法 第1代药物组：服用第1代抗精神病药的慢性精神分裂症男性患者25例;氯氮平组：服用氯氮平的慢性精神分裂症男性患者25例;对照组：身体健康的男性25名;3组的年龄和受教育年限均匹配.对上述3组进行听觉刺激惊跳反射检测,并使用阳性和阴性症状量表（PANSS）评定精神分裂症患者的临床精神病理症状.结果 （1）第1代药物组惊跳反射的反应波幅（SR）[（553.6±516.9）mV]明显低于对照组[（942.0±447.3）mV,P=0.009],氯氮平组的SR[（755.9±439.4）mV]介于上述2组之间,但与2组间的差异均无统计学意义（P＞0.05）;（2）第1代药物组惊跳反射的适应性（HAB）[（17.8±35.8）%]明显低于对照组[（44.9±28.9）%,P=0.027],氯氮平组的HAB[（22.9±34.1）%]介于上述2组之间,但与2组间的差异均无统计学意义（P＞0.05）;（3）当时间间隔（LI）为120 ms时,第1代药物组的惊跳反射弱刺激抑制（prepulse inhibition,PPI）显著小于对照组（P=0.024）,氯氮平组的PPI值介于上述2组之间,但与2组间的差异均无统计学意义（P＞0.05）;LI为30 ms或60 ms时,3组间PPI的差异无统计学意义（P＞0.05）;（4）第1代药物组和氯氮平组患者不同LI的PPI与其临床病理症状可能不存在相关（P＞0.05）.结论 精神分裂症患者可能存在听觉惊跳反射弱刺激抑制的缺陷;氯氮平可能能部分改善精神分裂症患者对惊跳反射的脱抑制.Objective To explore the deficits of acoustic startle reflex （ASR） that might exist in Chinese patients with schizophrenia and the effects of antipsychotics on ASR. Methods Participants included 25 male patients with chronic schizophrenia treated with typical antipsychotics （ typical group）, 25 with atypical antipsychotic clozapine （clozapine group） and 25 healthy male subjects （control group）matched for age and years of education. Startle reflex to acoustic stimuli were examined in all subjects from the three groups. At the same day of startle testing, psychopathological symptoms of the patients were assessed with the Positive and Negative Syndrome Scale （PANSS）. Results （1） Startle response（SR） was significantly reduced in typical group than in control group[ （553.6 ±516. 9） mV vs （942. 0 ±447. 3） mV,P =0. 009]. SR of clozapine group [ （755.9 ±439. 4） mV] was greater than that of typical group and less than that of control group, but there was no significant difference between clozapine group and the other two （ P 〉 0. 05 ）. （2） Habituation （HAB） of startle reflex in typical group was significantly lower than in control group [ （ 17. 8 ± 35. 8 ） % vs （44. 9 ± 28.9） %, P = 0. 027 ]. HAB of clozapine group [ （22. 9 ± 34. 1 ） % ]was higher than that of typical group and less than that of control group, but there was no significant difference between clozapine group and the other groups （ P 〉 0. 05 ）. （ 3 ） Compared with healthy controls,patients of typical group exhibited the significant reduction in prepulse inhibition （PPI） of startle reflex （P = 0. 024） when prepulse interval （LI） was 120 ms. PPI of clozapine group was higher than typical group and less than control group, but no significant differences in PPI were found between clozapine group and the other groups. While LI was 30 ms or 120 ms, PPI among the three groups did not show significantly different （P 〉 0. 05 ）. （4） No significant relationship was f

关 键 词：精神分裂症 惊吓反应 弱刺激抑制 

分 类 号：R749.3[医药卫生—神经病学与精神病学]