首发精神分裂症患者奥氮平治疗前后脑功能磁共振成像的对比分析  

Comparative Analysis of Brain Functional Magnetic Resonance Imaging of First-episode Schizophrenia Patients before and after Olanzapine Treatment

作　　者：董玉姝[1] DONG Yushu(Department of Psychiatry,Jilin Provincial Brain Hospital,Siping,Jilin Province,136000 China)

机构地区：[1]吉林省脑科医院精神科,吉林四平136000

出　　处：《中外医疗》2021年第28期174-177,共4页China & Foreign Medical Treatment

基　　金：吉林省卫生与健康技术创新项目(2020J117)。

摘　　要：目的围绕首发精神分裂症患者,分别在奥氮平治疗前、后,用功能磁共振成像(fMRI)评定其认知功能的图像基本特点。方法方便选取2020年1月—2021年1月该院收治的首发精神分裂症患者50例,分别在奥氮平治疗前、后,开展倒背数字作业的fMRI检查。用阳性与阴性症状量表(PANSS)以及在治疗过程中需进行处理的不良反应症状量表,对患者精神症状严重程度及不良反应发生情况进行评定。结果奥氮平治疗后,患者的PANSS减分率为(50±21)%,而总有效率为72%。在奥氮平治疗前,倒背数字作业有着比较广的激活范围,包含多个脑区(颖叶、顶叶、额叶等)。左侧额上回治疗后激活脑区计数13相比治疗前4多,差异有统计学意义(χ^(2)=5.741,P<0.05);治疗后左侧额叶腹外侧面激活平均体积(66±24)个体素较治疗前(14±2)个体素大,差异有统计学意义(P<0.05)。结论针对首发精神分裂症患者,其在发病初期便有工作记忆缺陷情况的存在,此缺陷可能与额下回激活低下以及左侧额上回激活低下相关,而采用奥氮平进行治疗,有助于其工作记忆缺陷状况的改善。Objective To focus on patients with first-episode schizophrenia,use functional magnetic resonance imaging(fMRI)to assess the basic image characteristics of their cognitive functions before and after olanzapine treatment.Methods 50 patients with first-episode schizophrenia treated in the hospital from January 2020 to January 2021 were conveniently selected.FMRI examination of inverted back digital operation was carried out before and after olanzapine treatment.Use the Positive and Negative Symptom Scale(PANSS)and the Adverse Reaction Symptom Scale that needs to be dealt with during the treatment process to evaluate the severity of the patient's mental symptoms and the occurrence of adverse reactions.Results After olanzapine treatment,the reduction rate of PANSS was(50±21)%,and the total effective rate was 72%.Before olanzapine treatment,back to back digital task has a wide range of activation,including multiple brain regions(glume lobe,parietal lobe,frontal lobe,etc.).The number of activated brain areas in the left superior frontal gyrus after treatment was 13,which was significantly higher than that before treatment 4 activated brain areas,the difference was statistically significant(χ^(2)=5.741,P<0.05).After treatment,the average activation volume(66±24)voxel of the ventral and lateral sides of the left frontal lobe was greater than that before treatment(14±2)voxel,and the difference was statistically significant(P<0.05).Conclusion For patients with first-episode schizophrenia,working memory deficits exist in the early stage of onset.This deficiency may be related to the low activation of the inferior frontal gyrus and the low activation of the left superior frontal gyrus,treatment with olanzapine is helpful for the improvement of working memory deficit.

关 键 词：精神分裂症 首发病 奥氮平 磁共振成像 认知功能 

分 类 号：R749.05[医药卫生—神经病学与精神病学]