首次发病的精神分裂症患者感觉门控P50特征及其相关因素  

Sensory gating P50 characteristics and its related factors in first-episode patients with schizophrenia

作　　者：陈大春[1] 李艳丽[1] 杨可冰[1] 王宁[1] 聂鹰[1] 张进国[1] 张向阳[1] 

机构地区：[1]北京回龙观医院,100096

出　　处：《临床精神医学杂志》2015年第4期217-220,共4页Journal of Clinical Psychiatry

基　　金：美国国立精神卫生研究所(NIMH)(H-22473)

摘　　要：目的：探讨首次发病的精神分裂症患者感觉门控P50特征及其相关临床因素。方法：给予87例首发未服药的精神分裂症住院患者（患者组）单一利培酮（4-6 mg/d）治疗,疗程10周;治疗前后分别进行阳性和阴性综合征量表（PANSS）评定及P50检测;以PANSS减分率50%分割点将患者分为有效组和无效组;P50检测结果与86名健康志愿者（对照组）比较;分析患者组P50指标与临床因素的关系。结果：患者组治疗前P50听觉条件（S1）、测试刺激（S2）潜伏期显著长于对照组,S1波幅及S1-S2波幅差值显著低于对照组,S2/S1显著高于对照组（P均〈0.01）;治疗后S1、S2波幅较治疗前显著下降（P均〈0.01）;有效组与无效组间P50各项指标差异无统计学意义;治疗前S2波幅与PANSS阳性症状分呈正相关;S1-S2波幅差值与病程、PANSS中一般精神病理分呈负相关;S2波幅/S1波幅与病程、PANSS总分及一般精神病理分正相关（P均〈0.05）。结论：首发精神分裂症患者P50抑制缺陷;其与患者的病程、精神病理症状相关;利培酮治疗对P50 S1、S2波幅有影响,但可能未改善其抑制缺陷。Objective： To investigate the sensory gating P50 characteristics,its related factors and the effects of risperidone in first-episode patients with schizophrenia. Method： Eighty-seven first-episode untreated patients with schizophrenia（ case group） received single risperidone（ 4- 6 mg / d） for 10 weeks. Before and after treatment,the patients were assessed by positive and negative syndrome scale（ PANSS） and detected by P50 respectively. With the segmentation point of 50% of PANSS reduction rate,the patients were divided into effective and ineffective groups. The results of P50 were compared with 86 healthy subjects（ control group）. The relationships were analyzed between the indicators of P50 and the clinical factors of the patients. Results：Compared to the control group,the incubation period of auditory conditions（ S1） and the test stimulus（ S2） in case group before treatment were significantly longer; the amplitudes of S1 and the difference of S1-S2 were significantly lower; the amplitude S2 / S1 was significantly higher（ all P〈0. 01）. After treatment,the amplitudes of S1,S2 were significant lower than before treatment（ all P〈0. 01）. The indicators of P50 between the effective and ineffective groups showed no significant difference. In case group before treatment S2 amplitude was positively correlated with PANSS positive symptoms score; the value of S1-S2 was negatively correlated with course and PANSS general mental pathological score; S2 / S1 was positively correlated with course,total score of PANSS and general mental pathological score（ all P〈0. 05）. Conclusion： There are sensory gating deficits associated in first-episode untreated patients with schizophrenia; which is correlated with the course and mental pathological symptoms of the patients. Risperidone can affect the amplitudes of S1,S2 of P50,but can not improve its inhibition of defects of the patients.

关 键 词：首发精神分裂症 利培酮 精神病理听觉感觉门控P50 

分 类 号：R749.3[医药卫生—神经病学与精神病学]