首次发病精神分裂症患者烟酸反应敏感度及认知功能特点分析  

Niacin sensitivity and cognitive functions in first episode schizophrenia

作　　者：王燕 张天宏[1] 徐丽华[1] 王继军[1] Wang Yan;Zhang Tianhong;Xa Lihua;Wang Jijun(Department of EEG and Imaging,Shanghai Mental Health Center,Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心脑电影像眼动研究室,200030

出　　处：《中华精神科杂志》2018年第6期367-372,共6页Chinese Journal of Psychiatry

基　　金：国家重点研发计划重大慢病防控研究专项(2016YFC1306803);国家自然科学基金(面上项目81671332,81671329);上海市优秀学术带头人计划项目(16XD1402400).

摘　　要：目的 探索首次发病精神分裂症患者的烟酸反应敏感度及认知功能特点.方法 采用横断面研究,对符合DSM-Ⅳ-TR中诊断标准的首次发病精神分裂症患者46例(患者组)及与其年龄、性别相匹配的健康对照者37名(对照组),进行烟酸反应敏感度检测并根据评分分为烟酸高反应和烟酸低反应,采用中文版认知成套测验进行认知功能评估.采用Spearman相关分析烟酸反应分数与PANSS症状评分之间的相关性.结果 烟酸浓度为0.000 1 mol/L时,患者组在10 min (t=-3.046,p=0.003)、20 min (t=-2.816,P=-0.032)时的平均反应分数低于对照组;烟酸浓度为0.001 mol/L时,患者组在10 rain (t=-2.211,P=0.030)、20 rain (t=-2.153,P=0.034)时平均反应分数低于对照组;烟酸浓度为0.01mol/L时,患者组在5 min (t=-2.812,P=0.006)时平均反应分数低于对照组;烟酸浓度为0.1 mol/L时,患者组在5 rain (t=-4.513,P<0.01)、10 min (t=-2.065,P=0.042)、15 min(t=-2.767,P=0.004)时平均反应分数低于对照组;差异均有统计学意义.在认知功能领域,烟酸低反应组较烟酸高反应组在连线测试[(41.50±2.96)分与(33.00±3.11)分],霍普金斯词语学习测试[(19.00±1.18)分与(22.30±1.56)分,视觉学习测试[(21.70±1.43)分与(26.3±1.79)分,]方面差异具有统计学意义(LSD检验,均P<0.05).烟酸反应分数与临床症状之间无相关性.结论 首次发病精神分裂症患者烟酸反应敏感度与认知功能均受损,且在信息处理速度、词语学习以及视觉学习方面烟酸反应较弱的精神分裂症患者受损程度更严重.Objective To explore the peculiarity of niacin sensitivity and cognitive functions in first episode schizophrenia.Methods Forty-six first episode schizophrenia outpatients and 37 healthy controls were matched by age and gender in this study.The differences of the niacin shin flushing scores and cognitive function were analyzed.Results Compared to healthy controls,subjects of first episode schizophrenia showed lower skin flush score at 0.000 1 mol/L aqueous methyl nicotinate (AMN)in 10 rain (t= -3.046,P=0.003) and 20 min(t=-2.816,P=0.032),at 0.001 mol/L in 10 min(t=-2.211,P=0.030) and 20 min (t=-2.153,P=0.034),at 0.01 mol/L in 5 min(t=-2.812,P=0.006),at 0.1 mol/L in 5 min(t=-4.513,P<0.01),10 min(t=-2.065,P=0.042)and 15 rain(t=-2.767,P=0.004).First episode schizophrenia showed impaired performance across all cognitive domains.Further analysis revealed that the niacin positive patient group and healthy controls niacin absent patient group performed significantly worse in trail making test (41.50± 2.96) vs.(33.00± 3.11),Hopkins verbal learning test (19.00± 1.18 vs.22.30± 1.56) and brief visuospatial memory test (21.70± 1.43 vs.26.3 ± 1.79) (LSD test,all P<0.05).There was no significant correlation between PANSS scores and niacin sensitivity.Conclusion Niacin sensitivity and cognitive functions might be reduced in first episode schizophrenia,while niacin absent patients could have worse impairment in processing speed,verbal memory and visual learning domains.

关 键 词：精神分裂症 烟酸类 认知 

分 类 号：R749.3[医药卫生—神经病学与精神病学]