探索性眼球活动与精神分裂症病情严重度的关系

Relationship between exploratory eye movements and clinical severity in schizophrenic patients

目的通过与正常人群对照,研究探索性眼球活动(EEM)与精神分裂症病情的关系,并探索EEM是精神分裂症的特征性标志还是状态性标志。方法48名精神分裂症患者在入院初、治疗第4周末和第8周末,分别用三套EEM进行检查,并评定阳性与阴性症状量表(PANSS)。对42名正常对照者进行类似的三次EEM检查。比较两组PANSS得分以及EEM的凝视点数(NEF)、反应性探索(RSS)、判别值(D)。NEF、RSS、D越高,越正常。结果精神分裂症患者基线的NEF(27.2±7.0)低于正常对照组(30.9±4.9),差异有统计学意义(t=-2.9,P=0.05),基线RSS(4.7±1.9)也低于正常对照组(12.1±3.9),差异有统计学意义(t=-11.7,P<0.01)。患者组治疗第8周NEF(29.9±5.0)较基线增加(t=-2.2,P=0.03),与对照组差异无统计学意义(t=-0.4,P=0.7),而RSS(4.7±1.4)与基线相似(t=-0.2,P=0.9),仍低于对照组(12.0±2.9),差异有统计学意义意义(t=-8.3,P<0.01)。结论EEM可作为精神分裂症的一种生物学标志,其NEF可能为状态性标志,而RSS则可能是特征性标志。

Objective： To investigate the relationship between exploratory eye movements （EEM） and clinical severity in schizophrenic patients. To clarify whether EEM is the trait marker or the state marker. Methods： All 48 schizophrenic patients and 42 normal controls underwent an exploratory eye movement test at baseline, 4 weeks and 8 weeks using three different sets of figures respectively. Symptoms of all patients were evaluated at the time of each test using the PANSS. Compared the PANSS score, the number of eye fixation （ NEF）, the responsive search score （RSS） and the discriminating score （D）. Results ： NEF （ 27.2 ± 7.0） and RSS （4.7 ± 1.9）of schizophrenic patients were significantly lower than those of the normal controls （NEE 30.9 ± 4.9; RSS 12. 1 ± 3.9） at baseline （P = 0.05 and P 〈 0.01 respectively）. For schizophrenia group at 8 weeks after treatment, NEF was increased compared with that of the baseline （t = - 2.0, P = 0.03 ）, and there was no statistical difference betwen two groups （ t = - 0.4, P = 0.7 ）. No change in RSS was observed among three EEM tests. RSS at 8 weeks after treatment in schizophrenia group was similar to that of the baseline （t = - 0.2 ,P = 0.9 ） and significantly lower than that of the control group （ t = - 8.3, P 〈 0.01 ）. Conclusion ： EEM as a biologic marker of schizophrenia, its NEF component may relate to the state of schizophrenia, which implicits that NEF may be a trait marker while RSS may be a characteristic state marker for schizophrenia.