早发与非早发精神分裂症认知功能比较研究

A comparative study of cognitive functions between early-onset schizophrenia and non- early- onset schizophrenia

目的比较早发与非早发精神分裂症患者认知功能缺损特征。方法对长期服氯氮平治疗（持续服用时间超过2年）且病程〉5年的住院精神分裂症患者按起病年龄分为两组，分别为早发精神分裂症患者组（起病年龄≤18岁）及非早发精神分裂症患者组（起病年龄〉18岁），进行阳性和阴性症状量表（PANSS）、重复性成套神经心理状态测验 （ Repeatable Battery for the Assessment of Neuropsychological Status,RBANS）及副反应量表（TESS）评定。结果（1）共纳入精神分裂症患者189例，其中早发精神分裂症患者组91例，非早发精神分裂症患者组98例，两组之间比较在发病年龄及年龄上存在有差异，而在性别，文化程度，病程，家族史，服氯氮平时间及剂量上均无显著差异；（2）早发组与非早发组之间比较，PANSS各因子、总分及TESS总分差异均无统计学意义（P〉0．05）；（3）早发组与非早发组之间比较，早发组在RBANS总分及即刻记忆因子分与语言因子分低于非早发组，差异有统计学意义（P〈0．05）。结论早发精神分裂症患者比非早发精神分裂症患者存在更严重的认知功能损害，主要表现在即刻记忆及语言上。

Objective To compare the cognitive impairment between early-onset schizophrenia and non-early-onset schizophrenia. Methods The chronic schizophrenics （the clinical course of disease 5 years） who bad received clozapine treatment in more than 2 years were recruited. The Positive and Neg- ative Syndrome Scale （ PANSS）, Neuropsychological Status （RBANS） and Treatment Emergent Symptoms Scale （TESS） were used to assess therapeutic efficacy, cognitive function and side effects. Results （1）189 chronic schizophrenics were recruited and divided into two groups, namely early-onset schizophrenia group （91 subjects） and the non-early-onset schizophrenia group （98 subjects）. There was a significant difference in age of onset and age of subjects between the two groups, but no difference in gender, educational level,duration of illness, family history, duration and the close of clozapine. （2）No significant difference was found in the scores of PANSS and TESS between early-onset schizophrenia group and non-ca＇fly-onset schizophrenia group （P〉 0.05）, （3）There was significant difference in total score and the Immediate Memory Factor score and Language Factor score of RBANS between the two groups. Conclusions The early-onset schizophrenia patients have more severe cognitive impairment than non- early-onset schizophrenia patients,especially on immediate memory and language.