长期住院稳定期精神分裂症患者认知功能及脑灰质密度的对照研究  

The control study between cognitive function and brain gray matter density of stable schizophrenic patients

作　　者：赵素华[1] 孔洁华[1] 吴海波[1] 杜碧茵[1] 

机构地区：[1]广州市精神病医院,510370

出　　处：《临床精神医学杂志》2013年第3期174-177,共4页Journal of Clinical Psychiatry

摘　　要：目的:探讨长期住院稳定期精神分裂症患者大脑结构形态学改变及其与精神病理学症状的关系。方法:对68例稳定期精神分裂症住院患者(患者组)与l7名正常对照(对照组)采用中文版精神分裂症认知功能成套测验共识版(MCCB)作为评价工具进行认知功能测评,以阳性与阴性症状量表(PANSS)评定患者精神症状,Pearson相关分析探讨二者之间的相关性。患者组与对照组均进行磁共振扫描。结果:研究组PANSS阴性症状评分平均(18.19±7.29)分高于阳性症状(l3.12±5.44)分。MCCB认知功能评估中,研究组在符号编码、言语流畅、持续操作、言语记忆、迷宫、情绪管理及总测验成绩与正常对照组差异有统计学意义(t=2.82～5.99,P<0.05或P<0.01)。Pearson相关分析显示,研究组PANSS总分及阴性症状与MCCB中符号编码、言语流畅、持续操作、言语记忆、情绪管理及总测验成绩等呈显著负相关(r=-0.25～-0.42,P<0.05或P<0.01)。基于体素的形态学方法(VBM)分析显示,研究组的左侧额上回,左侧额中回、左额内侧回、右侧楔叶、左侧颞中回的灰质密度显著低于正常对照(Z=3.16～4.08,P<0.05或P<0.01)。结论:稳定期精神分裂症患者以阴性症状为主,阴性症状越重,认知损害越明显;阴性症状持续与认知功能损害可能与左侧额叶灰质密度下降有关。Objective：To explore brain structure morphology change and the relationship between the symptoms and psychopathology of in stable schizophrenia patients. Method：A total of 68 schizophrenic patients in stable （ study group） and 17 healthy controls（ control group） were evaluated by using Chinese schizo- phrenia cognitive function test battery consensus edition （ MCCB） and positive and negative syndrome scale （ PANSS） . Pearson correlation was performed to determine the correlation between cognitive function and clinical features. And all the patients and the healthy controls finished magnatic resonance imaging（ MRI） scans. Results：In the PANSS results of study group,the average score of negative symptoms （ 18. 19 ± 7. 29） was higher than those of positive symptoms （ l3. 12 ± 5. 44） . In the cognitive function assessment of MCCB,there were statistical differences between the study and control group in terms of symbolic coding,verbal fluency,continuous operation,verbal memory,maze,emotion management and total test scores （ t = 2. 82 ～ 5. 99,P 0. 05 or P 0. 01） . The total scores of PANSS and negative symptom scores were negatively correlated with the symbolic coding,verbal fluency,continuous operation,verbal memory,emotion management and total test scores of MCCB （ r = -0. 25 ～ -0. 42,P 0. 05 or P 0. 01） in study group. The analysis of voxel-based morphometry showed that the gray matter density in the left superior frontal gyrus,left middle frontal gyrus,left medial frontal gyrus, right cuneus and left middle temporal gyrus of the study group were significantly lower than those of the control group（ Z = 3. 16 ～ 4. 08,P 0. 05 or P 0. 01） . Conclusion：The main syndromes of stable schizophrenia patients are negative ones. The more severe the negative symptoms is,the more significant cognitive function be impaired. The negative symptoms and the cognitive impairment may associate with reduction of gray-matter-density in the left frontal lobe regions .

关 键 词：精神分裂症 认知功能 脑灰质密度 

分 类 号：R749.3[医药卫生—神经病学与精神病学]