663例精神分裂症患者的临床特征与头颅CT异常的相关分析  

Analysis of Clinical Characteristics and Brain CT Abnormal Changes of 663 Schizophrenia Patients

作　　者：贾军朴[1] 董杰[1] 张宇[1] 

机构地区：[1]首都医科大学附属北京安定医院

出　　处：《中国病案》2015年第6期F0002-F0002,F0003,M0002,共3页Chinese Medical Record

摘　　要：目的通过分析精神分裂症患者的临床特征与其头颅CT变化的关系,探讨头颅CT在精神分裂症诊断中的辅助价值。方法回顾性分析了663例采用ICD-10诊断标准诊断为精神分裂症患者的病案资料,对其脑部CT的影像资料及各种临床特征进行了统计分析。结果患者的年龄越大,其脑萎缩发生率明显增高;透明间隔腔的出现与年龄的增大有关;精神分裂症病程越长,其颞叶脑沟裂的增宽和侧脑室的扩大概率的增加分别为10.2%和14.6%;复发次数的增加与脑萎缩无显著相关性,但复发次数越多,发生松果体囊肿的概率增加49.3%;精神分裂症的阴性症状为主与阳性症状为主的病例相比,前者头颅CT变化较后者更多,但差异并无显著的统计学意义;有自杀企图和行为的患者与没有自杀企图和行为的患者其脑实质的改变有显著差异。结论精神分裂症患者脑萎缩改变与患者的年龄、病程呈正相关;阴性症状为主的患者头部CT异常改变集中在额叶和顶叶,而阳性症状为主的患者头部CT异常改变集中在额叶和颞叶。Objective The paper probes into the auxiliary value derived from cranial CT in diagnose of schizophrenia by the method of analysis of the relationship between the schizophrenic clinical features and the change of cranial CT images. Methods The brain CT images and diverse clinical features are retrospectively analyzed by statistic approach on the basis of 663 medical records which were diagnosed as schizophrenia according to ICD-10. Results The incidence of cerebral atrophy is likely to increase as the age increases. Appearance of septum pellucidum correlates with age. The probabilities of broadening of cerebral sulci of temporal lobe and expansion of lateral ventricle increase 10.2% and 14.6% while the course gets long. Frequency of recurrence shows no significant relation towards the cerebral atrophy, whereas pineal cyst is more 49.3% likely to occur as the recurrence grows. Patients with negative symptoms showed more cranial CT changes than those with positive ones though the disparity is not statistically significant. And it could be found that the change of brain parenchyma between patients who have history of suicidal behavior or attempt and ones not having is significant. Conclusion Positive correlation is observed between cerebral atrophy and course as well lobe among patients with negative symptoms, while temporal lobe. as age. CT changes are often seen in parietal lobe and frontal the positive ones tend to show changes in parietal lobe and temporal lobe.

关 键 词：精神分裂症 头颅CT 临床特征 

分 类 号：R749.3[医药卫生—神经病学与精神病学]