首发精神分裂症与双相情感障碍Ⅰ型患者听觉感觉门控P50的比较  

Comparation of P50 auditory sensory gating between first episode schizophrenia and bipolar Ⅰ disorder

作　　者：李喆[1] 郑重[2] 邓伟[1] 刘祥[1] 李寅飞[1] 李涛[1] 

机构地区：[1]四川大学华西医院心理卫生中心,610041 [2]四川大学华西医院神经生物检测中心,610041

出　　处：《神经疾病与精神卫生》2014年第3期224-228,共5页Journal of Neuroscience and Mental Health

基　　金：国家自然科学基金项目（81130024）;四川省卫生厅课题（130039）

摘　　要：目的 比较首发精神分裂症患者与伴精神症状史的双相情感障碍Ⅰ型患者的听觉感觉门控P50（SG P50）及其与临床特征的相关性.方法 比较40例首发精神分裂症患者（精神分裂症组）,50例伴精神症状史的双相情感障碍Ⅰ型患者（双相情感障碍组）以及50例健康对照（对照组）SG P50;阳性和阴性症状量表（PANSS）评估精神分裂症组症状,汉密尔顿抑郁量表（HAMD）及杨氏躁狂量表（YMRS）分别评估双相情感障碍组抑都发作和躁狂发作症状,大体功能评定量表（GAF）评定3组总体功能水平;偏相关分析患者组P50同临床特征的关系.结果 两患者组较对照组以及精神分裂症组较双相情感障碍组的S1-S2波幅差值、P50抑制度均降低,S2/S1波幅比均增高,差异有统计学意义（P＜0.01）.双相情感障碍组S1-P50波幅最低,精神分裂症组S2-P50波幅最高,与其他两组比较差异均有统计学意义（P＜0.01）.精神分裂症组P50与其临床特征无相关性（P＞0.05）;双相情感障碍组P50部分指标与其临床特征有相关性（P＜0.05）.结论 首发精神分裂症与伴精神症状史的双相情感障碍Ⅰ型患者均有听觉SG P50抑制缺陷,前者更重,而受损机制可能既有重叠也有独立;P50抑制可能是精神疾病的素质性标记,情感障碍的状态性标记.Objective To detect the P50 auditory sensory gating in first episode schizophrenia and bipolar Ⅰ disorder with psychotic history and the relationship between P50 and clinical variables.Methods Conditioning （S1）-testing （S2） stimulus paradigm was used to record P50 in 40 patients with first episode schizophrenia （FES）,50 patients with psychotic history bipolar Ⅰ disorder （PBP） and 50 unrelated healthy controls （HC）.The clinical status of patients with schizophrenia and bipolar Ⅰ disorder were determined using PANSS and HAMD,YMRS respectively.The functioning status was assessed using GAF among the three groups.Partial correlations were computed to explore associations among the P50 in FES,PBP and the clinical data.Results Both patients groups showed significantly higher S2/S1 ratio,lower S1-S2 amplitude,and lower P50 suppression degree than HC group （P ＜ 0.01） and FES group also showed significantly higher S2/S1 ratio,lower S1-S2 amplitude,and lower P50 suppression degree than PBP group （P ＜ 0.01）.PBP group showed significantly lower S1 amplitude than the other two groups （P ＜ 0.01）.FEP group showed significantly higher S2 amplitude than the other two groups （P ＜ 0.01）.No correlation has been found between P50 and clinical variables in FEP group （P ＞ 0.05）,whereas,P50 suppression correlated positively with clinical variables in PBP group （P ＜ 0.05）.Conclusions Generalized abnormalities of P50 exist in FEP and PBP,but the former impaired more serious.The FEP and PBP may have overlapping and independent neuropathological changes.P50 suppression may represent the trait marker of psychosis and the state marker of affective disorder.

关 键 词：精神分裂症 双相情感障碍 感觉门控 听觉P50电位 

分 类 号：R971.4[医药卫生—药品]