首发精神分裂症患者治疗前后认知功能损害的比较  

Longitudinal study of cognitive impairment in first-episode schizophrenia

作　　者：何宗岭[1] 黄吉林[1] 李涛[2] 李云歌[1] 袁茵[1] 段明君[1] 

机构地区：[1]成都市第四人民医院 [2]四川大学华西医院心理卫生中心

出　　处：《中国神经精神疾病杂志》2013年第7期411-415,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：四川省卫生厅科研基金(编号:110038)

摘　　要：目的探索首发精神分裂症认知功能损害的特征,以及与精神症状的相关性。方法对30例首发精神分裂症患者,采用成套认知功能评估工具(the Cambridge Neuropsychological Test Automated Battery,CANTAB),评估记忆、注意功能、空间工作记忆及执行功能,采用阳性与阴性症状量表(the positive and negative syndromescale,PANSS)评估精神症状;并在治疗4周后再次评估认知功能和精神症状。同时,对30名正常对照进行认知功能测评。结果与对照组相比,患者组治疗前的持续注意、视觉记忆和空间工作记忆均较差(P<0.05),但执行功能无组间差异(P>0.05);治疗前,认知功能指标与PANSS各项因子无统计学相关性(P>0.05);治疗4周后,患者组认知功能水平与治疗前相比差异无统计学意义(P>0.05)。结论首发精神分裂症患者在发病初期即存在视觉记忆、持续注意及空间工作记忆受损,且独立于精神症状,在发病后的短时期内保持相对稳定。Objective The aim of this study was to investigate the changes of cognitive function in treatment-naive first episode schizophrenia, and to study the correlation between cognitive function and clinical symptoms. Methods Thirty treatment-naive first episode schizophrenia （FES） patients and thirty control subjects matched in age, gender and years of education were assessed using the Cambridge Neuropsychologieal Test Automated Battery （CANTAB）. The visual memory, sustain attention, working memory and executive function were measured at baseline and after a four-week ther- apy. The positive and negative syndrome scale （PANSS） was used to evaluate clinical symptoms. The relationship be- tween cognitive function and clinical symptoms in schizophrenia was assessed. Results Compared with the controls, the treatment-naive first episode schizophrenia patients displayed impairment in cognitive tasks in visual memory, sustain at- tention and working memory （all P〈0.05） but not in executive function （P〉0.05）. The scores on all cognitive function tests were not significantly associated with PANSS （all P〉0.05）. The cognitive function was not significantly different between baseline and four week follow-ups （all P〉0.05）. Conclusion Sustained attention, visual memory and working memory are impaired whereas executive functions are intact in treatment-naive first episode schizophrenia patients. Cognitive impair-ment of patients with first episode schizophrenia is independent of psychiatric symptoms.

关 键 词：精神分裂症 认知功能 精神症状 

分 类 号：R749.3[医药卫生—神经病学与精神病学]