精神分裂症的脑萎缩及其相关因素的分析

A study of global atrophy and its relative factors in schizophrenia.

目的 探讨精神分裂症患者脑萎缩的发生率及其相关因素。方法 对 14 2例精神分裂症患者 (病例组 )和 46例正常人 (对照组 )进行了脑部磁共振 (MRI)检查 ,对其临床相关因素进行了分析。结果 精神分裂症患者的脑萎缩发生率为 3 1 7% ;两组脑萎缩发生率和脑萎缩评分 (GA分 )、第三脑室最大宽度 (TVW )、前角指数 (FHI)、脑室脑比率(VBR)的值均有显著性差异 ;病例组的GA评分、TVW、FHI、VBR的值均与病前适应能力、病程、阴性症状量表总分、副反应量表总分等有显著相关性 ,而与性别、年龄、家族史、起病形式、阳性症状量表总分、简明精神病评定量表总分、脑电图异常、药物治疗总时间、药物最大日剂量、住院次数、电休克治疗次数、临床疗效总评量表的疗效总评项目分等无显著相关性。结论 本研究提示 ,精神分裂症可能与非特异性脑室、脑沟结构异常有关 ,特别是与脑萎缩程度有关 。

Objective In order to determine the positive rate of global atrophy(GA) and its relative factors in schizophrenic patients.Methods 142 schizophrenic patients and 46 normal controls were evaluated by magnetic resonance imaging(MRI),using quantitative measures of ventricular size and sulcal prominence,the relationship between GA and its relative factors studied with relative analyses in schizophrenic patients.Results An overall 31.7% of the positive rate for GA was found in the schizophrenic sbjects compared with the control group.The significant differences were observed in positive rate of GA,the scores of GA,maximum width of the third ventricle(TVW),the frontal horn index(FHI) and the ventricular-brain ratio(VBR) between schizophrenias and normal controls.The relationship between the scores of GA,TVW,FHI,VBR and the maladjustment of social before onset,the courses of the disease,the total score of scale for the assessment of negative symptoms,the treatment emergent symptoms scale in schizophrenias were quite close.But the scores of GA,TVW,FHI,VBR did not show definite relations to the sex,the age of patients,the positive family history,the total scores of scale for the assessment of positive symptoms,the brief psychiatric rating scale,EEG abnormal,the times of drug treatment,the maximal dosage of drug,the times of hospitalization and ECT,the score of clinical global impression-general improvement.Conclusions It was suggested that the schizophrenia may probably associated with non-specific brain abnormalities in ventricular size and sulcal prominence,especialy global atrophy.