精神分裂症患者脑器质性改变和认知障碍的发生因素

Brain organic changes and pathogenesis of cognitive impairment in patients with schizophrenia

目的:精神分裂症患者的脑器质性改变和认知障碍的发生机制、疾病的治疗和康复仍未明确,是现代精神科研究的主要内容之一,根据相关研究结果,结合神经生物学的有关研究进展,探讨其发病的因素及相关特征。资料来源:通过手工检索1994-2004年有关精神分裂症的部分中文书籍和专业期刊杂志,检索其中有关精神分裂症和神经生物学研究现状的文章。检索词“精神分裂症,病因,发病机制,影像学研究,组织解剖学研究”,限定文章语言种类为汉语。资料选择:对资料进行初审,选取符合要求的有关文献。纳入标准:①有关精神分裂症的病因、发病机制的研究原著。②有关精神分裂症影像学研究、组织解剖学的研究原著。③有关神经生物学研究现状的资料。排除标准为:文献中重复的文章。资料提炼:共收集到9部书籍和12篇有关精神分裂症病因、发病机制、影像学、组织解剖学等方面的研究资料,以及4部有关神经生物学方面资料的书籍。共纳入12篇(部)。其中精神分裂症的病因和发病机制研究的资料3篇,精神分裂症的影像学和组织解剖学的研究资料4篇,神经生物学方面的研究资料4篇,有关认知障碍的研究资料1篇。资料综合:根据所得资料可以推测,精神分裂症的脑器质性改变,多是精神分裂症的异常功能性脑基因,在大脑的发育期,低丰度表达的异常功能产物通过影响相应的神经发育而导致的,在大脑发育成熟期的发病期,高丰度表达的异常功能产物导致了相应的神经元功能的特性异常,并通过大脑的可塑性而导致的。精神分裂症的认知障碍是其脑器质性改变的功能体现。结论:精神分裂症是基因水平、分子水平的器质性疾病,是神经元功能异常的功能性疾病,可导致细胞水平的脑组织结构的器质性改变,并表现出相应的认知障碍。

OBJECTIVE： The brain organic changes, pathogenesis of cognitive impairment, treatment and rehabilitation in patients with schizophrenia are still not clear, and are one of the main contents in the study of modern psychiatry, This paper probed into the factors and related characters of the attack of schizophrenia according to the relevant investigative outcomes in combination with the investigative progress in neurobiology. DATA SOURCES： Some Chinese books and professional journals about schizophrenia between 1994 and 2004 were manually retrieved, and the articles about the present status of study about schizophrenia and neurobiology were also searched, the keywords were ＂schizophrenia, etiological factor, pathogenesis, imaging, histoanatomy＂ in Chinese. STUDY SELECTION： The data were checked firstly, those accorded with the inclusive criteria were selected. Inclusive criteria： （1） original works about the etiological factor and pathogenesis of schizophrenia; （2） original works about the imaging and histoanatomy of schizophrenia; （3） data about the present status of study about neurobiology. Exclusive criteria： repetitive studies, DATA EXTRACTION： Totally 9 books and 12 articles about the etiologic, al factor, pathogenesis, imaging and histoanatomy Of schizophrenia, and 4 books about neurobiology were collected, and 12 articles （books） were involved, including 3 about the etiological factor and pathogenesi＇s of schizophrenia, 4 about the imaging and histoanatomy of schizophrenia, 4 about neurobiology, and 1 about cognitive impairment. DATA SYNTHESIS： It can be suspected from the obtained data that most brain organic changes of schizophrenia are caused by schizophrenic abnormal functional brain gene. At the development phase of brain, it is induced by the low-abundance expressed abnormal functional product through affecting the development of corresponding nerves. At the attack of mature phase of brain development, it was caused by the high-abundance expressed abnormal functional product in resulting in the abnormal character of neuron function and through the plasticity of brain. The schizophrenic＇ cognitive impairment is the functional reflection of its brain organic changes. CONCLUSION： Schizophrenia is an organic disease of gene and molecular levels, also a functional disease of neuron functiona! abnormality, it can lead to the organic changes of brain tissue structure of cellular level, and manifests corresponding cognitive impairment.