首发与复发精神分裂症患者空间认知功能的差异研究

The difference of spatial cognitive function between first--episode and recurrent schizophrenia

目的探讨首发与复发精神分裂症患者空间认知功能的差异。方法对30例精神分裂症首次发作患者（首发组）、32例复发精神分裂症患者（复发组）进行视觉空间旋转任务的测定，测量其错误数和反应时，并与30名健康志愿者的结果进行比较。结果（1）与对照组（8．6±2．7）％相比，首发组（26．8±8．4）％、复发组（35．3±9．6）％错误率均显著升高，且首发组错误率低于复发组，差异有统计学意义（P〈0．05）。（2）与对照组（722．5±76．8）ms相比，首发组（801．2±85．1）ms、复发组（863．1±87．2）ms反应时显著延长，且首发组反应时显著短于复发组（P〈0．05）。（3）首发、复发组错误率、反应时正镜像差异消失（P〉0．05）。（4）线性回归分析发现，对照组正镜像错误率、反应时均随着旋转角度递增呈线性递增函数（P〈0．01）；首发、复发组正镜像错误率、反应时均没有随着旋转角度递增呈线性递增函数（P〉O．05）。结论首发、复发精神分裂症患者视觉空间认知功能均受损，更多受损发生在镜像转化为正像的平面外旋转，且复发患者受损程度大于首发患者。提示空间认知功能受损可能为一种更严重的继发性高级认知功能障碍。

Objective To explore the difference in visio--spatial cognitive function between first-- episode and recurrent schizophrenia （Sz）. Methods Totals of 30 patients with first--episode and 32 recurrent Sz from third hospital of PLA were tested to make visuo--spatial rotation tasks with measuring er- rors and response times. Another 30 healthy controls were also tested as control group. Results （1） Com- pared to the controls （8.6±2.7） %, the error rate was higher in first--episode[（26.8±8.4） %, P〈 0.05） ] and recurrent Sz [（35.3±9.6）%, P〈 0.05） ]. Compared to first--episode group, the error rate was higher in recurrent Sz （P〈 0.05）. （2） Compared to the controls （722.5±76.8） ms, the response time was longer in first--episode [（801.2±85.1） ms, P〈 0.05） ] and recurrent Sz [（863.1± 87.2） ms, P 〈 0.05）]. Compared to first--episode group, the response time was longer in recurrent Sz （P 〈 0, 05）. （3） The error rate and response time between normal and mirror were no difference in the first--episode and recurrent Sz （P 〉 0.05）. （4） Linear regression analysis showed the mirror and normal error rates in the controls were gradually linearly decreasing with the angle of rotation （P 〈 0.01）. But these effects were not found in first--episode and recurrent Sz （P 〉 0.05）. Conclusions The first--episode and recurrent Sz present deficiency on cognitive function of visuo--spatial rotation, and more deficiency in the outside rotation on the conversion between normal and mirror. And the recurrent Sz present more severe impairment. These suggest that the impaired spatial cognitive function may be more serious advanced secondary cognitive dysfunction and such impairment may also be an important and possibly defining marker of Sz in particular.