首发精神分裂症患者认知功能相关因素的5年随访

A 5-year follow-up on cognitive function of first-episode schizophrenic patients

目的探讨首发精神分裂症患者在急性期和维持治疗期认知功能与精神症状和社会功能的关系。方法对164例首发精神分裂症患者进行随访观察,于治疗前、治疗12周末、治疗1年末、2年末、3年末、4年末、5年末各做1次韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能协调测验、连线测验A和B、威斯康星卡片分类测验(WCST)及言语流利性测验等10项神经心理测查及简明精神症状评定量表(BPRS)、阴性症状评定量表(SANS)、功能总体评定量表(GAF)评定。结果治疗前各项认知功能测查结果与BPRS、SANS、GAF均无显著相关(P>0.05);治疗12周末、治疗1年末、2年末手指敲击测验、动作功能测验、总记忆商(MQ)等与BPRS总分显著相关(P<0.003);治疗12周末、治疗1年末、2年末、3年末、5年末铁槽铁钉测验、手指敲击测验、手功能协调性测验、智商(IQ)、MQ等与SANS、GAF总分显著相关(P<0.003)。结论治疗前首发精神分裂症患者认知功能与阳性症状、阴性症状、社会功能相互独立;维持治疗期随着疾病的演变,它们之间的相关性也在发生着变化。

Objective To investigate cognitive function and related factors of psychotic symptoms and social function of first-episode schizophrenic patients during acute and maintenance treatment period. Methods Total of 164 patients with first-episode schizophrenia were evaluated before treatment, at the end of 12 weeks treatment and then annually till 5 years on 10 cognitive function tests, including Wesehler adult intelligence scale, Weschler memory scale, grooved pegboard test, finger tapping test, motor function test, hand coordination test, trail making test A and B, Wisconsin card sort test, and verbal fluency test, together with BPRS, SANS and GAF. Results The scores on all cognitive function tests were not significantly related to total scores of BPRS, SANS and GAF before treatment. Scores on finger tapping test, motor function test, and memory quotient（MQ） were related to BPRS total scores with statistical significance at the end of 12 weeks, 1 year and 2 years treatment. Scores on grooved pegboard test, finger tapping test, a motor function test, intelligence quotient （IQ）, MQ were correlated to SANS total scores, GAF total scores with statistical significance at the end of 12 weeks, 1 year, 2 years, 3 years and 4 years treatment. Conclusions Cognitive impairment of patients with first-episode schizophre- nia were independent to positive symptoms, negative symptoms and social function, through during maintain treatment perod, the relationship between cognitive tests and negative symptoms, positive symptoms changed.