35例精神分裂症患者神经心理学评估的对照研究

A Control Study of Neuropsychological Function in 35 Schizophrenic Patients

目的:用神经心理测验评估35例精神分裂症患者认知功能损害的特点。方法:采用多种神经心理测验评估35例精神分裂症患者(12例未用药,8例用药1周以内,15例用药1月以上)和20例健康对照组的学习、记忆、工作记忆、注意、信息处理速度、词语流畅、执行功能等认知功能。对未用药和用药1周以内的精神分裂症患者进行随访。结果:在成套神经心理测验的各个分测验中,精神分裂症患者(未用药、用药1周以内和用药1月以上)成绩均较正常人差[如韦氏数字符号得分未用药者(63.0±13.8),正常对照组(87.10±13.16),P<0.001]。用药1月以上组的空间广度测验成绩优于未用药组[逆行得分成绩用药1月以上组(7.47±1.81),未用药组(5.50±1.73),P<0.01;总分成绩用药1月以上组(15.33±3.31),未用药组(12.42±3.65)]。随访研究中,霍普金斯词汇学习测验-修订版、简易视觉空间记忆测验-修订版和视觉空间广度测验的随访成绩优于初测成绩[如空间广度测验的逆行得分初测成绩(5.7±1.5),随访成绩(6.8±1.0,P<0.05)]。结论:精神分裂症患者存在大脑广泛的认知功能损害。非经典抗精神病药物治疗可能对精神分裂症患者的言语记忆、视觉空间记忆和视觉工作记忆有所改善。

Objective： To evalnate the neurocognitive function in 35 schizophrenia patients by a series of standardized neuropsychologieal tests. Methods： Thirty-five schizophrenia patients including patients untreated （ n = 15）, treated with anti-psychotics less than 1 week （ n = 8 ）, or more than 1 month（ n = 15 ） , 20 matched healthy controls were involved, and 12 patients including unmedicated （ n = 6） and medicated less than 1 week （n = 6） were followed up after 4 weeks. Patients and controls were evaluated by several neuropsychologieal tests designed to measure learning, memory, attention, information processing and executive function. Results： Healthy controls performed better than schizophrenia patients in the majority of cognitive tests （ P 〈 0. 05 ） . In the Spatial Span Test, patients who were medicated more than 1 month performed better than patients who were unmedicated （ P 〈 0. 051 An improvement was found at follow-up in both patient groups （ P 〈0. 05 ） in the Hopkins Verbal Learning Test-Revised （ HVLT-R）, Brief Visuospatial Memory Test-revised （ BVMT-R ） and Spatial Span Test. Conclusion： The findings indicate that schizophrenia patients exhibit a wide range of impairments incluoling learrning, memory, working memory, attention/concen, tration, information processing, and executive function, Although autipsychotics have not significantly changes on the neurocognitive function in schizophrenia patients, the unmedicated patieuts＇nenrocognitive function are wgrse, and the antipsyehotics might have some effects on verbal memory visual-spatial memory and visual working memory.