首发精神分裂症的P50感觉门控与临床症状的关系  

The study on the correlation of P50 sensory gating with clinical symptoms in first-episode schizophrenics

作　　者：王俊清[1] 叶兰仙[2] 许崇涛[1] 

机构地区：[1]汕头大学精神卫生中心,汕头515063 [2]兰州大学第二医院心理科

出　　处：《中国神经精神疾病杂志》2010年第10期607-611,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金资助项目(编号:30670756);广东省自然科学基金资助项目(编号:04020238);广东省医学科研基金资助项目(编号:A2010415)

摘　　要：目的探讨精神分裂症患者P50感觉门控与临床症状的关系。方法运用条件-测试刺激模式和刺激序列模式检测72例首发精神分裂症患者抗精神病药物治疗6周前后的P50听觉诱发电位,并以36名正常人为对照组。采用阳性和阴性症状量表(positive and negative syndrome scale,PANSS)评定治疗前后的临床症状,比较阳性症状为主组(阳性组)与阴性症状为主组(阴性组)患者的P50;采用多元回归分析P50抑制及其治疗前后变化与PANSS评分的关系。结果治疗前,条件-测试刺激模式下阳性组与阴性组患者均较对照组的T-P50波幅升高而P50抑制降低(P<0.05),而刺激序列模式下有较高的高频刺激P50波幅和较低的P50抑制(P<0.05)。但无论是治疗前还是治疗后,两个患者亚组之间两种模式P50诱发电位各成分、P50抑制的差异均无统计学意义(P>0.05),而多元回归分析显示,总的患者组中治疗前两种模式P50抑制与PANSS总分及各因子分均无明显相关(P>0.05),但条件-测试刺激模式P50抑制的变化率与PANSS的激活性因子分变化率相关(b=0.39,P<0.05),刺激序列模式P50抑制变化率分别与激活性因子分和抑郁因子分的变化率相关(b=0.44,P<0.05;b=0.49,P<0.05)。结论本研究未发现精神分裂症患者的P50感觉门控异常与其主要临床症状群相关,但P50抑制的变化可能是反映患者的激越或抑郁情绪变化有关的电生理标记。Objective To explore the correlation of P50 sensory gating with clinical symptoms in first-episode schizophrenics.Methods Conditioning-testing stimulus paradigm and stimulus train paradigm were used to record the P50 auditory evoked potential in 72 first-episode schizophrenics before and after treatment and in 36 normal controls.Positive and negative syndrome scale （PANSS） were used to evaluate clinical symptoms,to compare the difference of the P50 components between the positive group （with prominent positive symptoms） and the negative group （with prominent negative symptoms）,and to explore the association of P50 treatment with PANSS scores.Results Before treatment,both of the positive and negative groups had higher levels of T-P50 amplitude,lower levels of P50 suppression in conditioning-testing stimulus paradigm and higher levels of P50 amplitude,lower levels of P50 suppression evoked by high frequency stimuli in stimulus train paradigm compared with controls （P0.05）.But the difference of the P50 components and P50 suppression were not significant between patient subgroups either before or after treatment （P0.05）.In all patients,multiple linear regression analysis showed that P50 suppression obtained before treatment in two paradigms were not related to the PANSS total score and subscores（P0.05）,whereas P50 suppression change ratio obtained after treatment was related to the PANSS agitation factor subscore change ratio in conditioning-testing stimulus paradigm（b=0.39,P0.05）,and related to the PANSS agitation factor subscore and depression factor subscore change ratio in stimulus train paradigm（b=0.44,P0.05;b=0.49,P0.05）.Conclusions We can not find any correlation of P50 sensory gating deficit with principal clinical symptoms in schizophrenics.However,P50 suppression change ratio may be a electro-physiologic index which reflects changes in patient＇s agitation or depression.

关 键 词：首发精神分裂症 条件-测试刺激模式 刺激序列模式 P50感觉门控 

分 类 号：R749.3[医药卫生—神经病学与精神病学]