双相情感障碍、精神分裂症患者CT图像脑形态及认知功能受损特点和差异  

Characteristics and differences of brain morphology and cognitive function impairment in patients with bipolar affective disorder and schizophrenia on CT images

作　　者：赵建峰 庄献鹏 陈佳 邓荔元 王娜娜 ZHAO Jianfeng;ZHUANG Xianpeng;CHEN Jia;DENG Liyuan;WANG Nana(Liaocheng Fouth People's hospital,Liaocheng 252200,Shandong,China)

机构地区：[1]聊城市第四人民医院,山东聊城252200

出　　处：《西部医学》2024年第10期1541-1545,共5页Medical Journal of West China

基　　金：济宁市重点研发计划项目(2020JN007)。

摘　　要：目的探讨双相情感障碍、精神分裂症患者CT图像脑形态及认知功能受损特点和差异。方法选取2019年1月-2022年12月在我院治疗的双相情感障碍患者53例(双相情感障碍组)、精神分裂症患者49例(精神分裂症组)。两组患者均给予颅脑CT检查,观察患者脑形态,采用MATRICS共识认知成套测验(MCCB)、威斯康辛卡片分类测验(WCST)、数字广度和数字符号测试评估患者认知功能,采用阴性与阳性症状量表(PANSS)评估精神分裂症患者症状严重程度。结果两组患者颅脑CT图像哈氏值、第三脑室最大宽度、侧脑室体部指数、脑室指数和脑萎缩评分比较差异无统计学意义(P>0.05)。精神分裂症组患者MCCB测试项语言能力和操作能力各项评分均明显低于双相情感障碍组(P<0.05)。精神分裂症组患者WCST测试分类数明显低于双相情感障碍组患者,而错误数和持续错误数明显高于双相情感障碍组患者(均P<0.05)。精神分裂症组患者数字广度测试倒背评分、数字符合测试评分明显低于双相情感障碍组(P<0.05)。精神分裂症组不同PANSS评分患者颅脑CT图像参数比较差异无统计学意义(P>0.05);PANSS评分≥60分患者MCCB测试言语记忆、语言能力总分、符号编码、持续操作、空间广度、数字序列、操作能力总分明显低于PANSS评分<60分患者(P<0.05);精神分裂症PANSS评分≥60分患者WCST测试分类数明显低于PANSS评分<60分患者,而错误数、持续错误数明显高于PANSS评分<60分患者(均P<0.05);精神分裂症PANSS评分≥60分患者数字广度测试倒背评分、数字符合测试评分明显低于PANSS评分<60分患者(P<0.05)。结论双相情感障碍和精神分裂症患者CT图像脑形态无明显差异;与双相情感障碍比较,精神分裂症患者认知功能受损较严重,且与患者症状严重程度有关。Objective To explore the characteristics and differences of brain morphology and cognitive function impairment in patients with bipolar affective disorder and schizophrenia on CT images.Methods 53 patients with bipolar disorder and 49 patients with schizophrenia who were treated in our hospital from January 2019 to December 2022 were selected,both groups were given brain CT to observe the brain morphology,the cognitive function of patients was evaluated by using the MATRICS Consensus Cognitive Test(MCCB),Wisconsin Card Sorting Test(WCST),digit span and digit sign test,and the severity of symptoms of schizophrenia was evaluated by using the Negative and Positive Symptom Scale(PANSS).Results There was no significant difference in the Hastelli value,the maximum width of the third ventricle,the body index of the lateral ventricle,the ventricular index and the brain atrophy score of the patients with bipolar affective disorder and schizophrenia(P<0.05).The MCCB test scores of schizophrenia patients were significantly lower than those of bipolar disorder patients(P<0.05).The number of WCST classification in schizophrenia was significantly lower than that in bipolar disorder(P<0.05),while the number of errors and persistent errors was significantly higher in bipolar disorder(P<0.05).The number span test inverted score and number coincidence test score of schizophrenia patients were significantly lower than those of bipolar disorder patients(P<0.05).There was no significant difference in brain CT image parameters among patients with different PANSS scores in schizophrenia(P>0.05).The total scores of speech memory,language ability,symbol coding,continuous operation,spatial breadth,number sequence and operation ability of patients with schizophrenia with PANSS score≥60 were significantly lower than those with PANSS score<60(P<0.05).The classification number of WCST test in patients with PANSS score≥60 was significantly lower than that in patients with PANSS score<60(P<0.05),while the number of errors and persistent err

关 键 词：双相情感障碍 精神分裂症 CT图像脑形态 认知功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]