男性慢性精神分裂症患者吸烟行为与认知功能的关系

Relationship between Smoking Behavior and Cognitive Function of Male Patients with Chronic Schizophrenia.

目的探讨男性慢性精神分裂症患者吸烟与认知功能的关系。方法符合中国精神障碍分类与诊断标准3版(CCMD-3)精神分裂症诊断标准的男性住院病人195例,其中吸烟患者121例,非吸烟患者74例,使用住院病人烟草使用状态调查表、尼古丁依赖严重程度量表(FIND)对患者吸烟状况进行调查,使用威斯康星卡片分类(WCST)、重复性成套神经心理状态测验(RBANS)检测认知功能。结果精神分裂症男性患者吸烟组和非吸烟组在WCST各项指标上差异均无统计学意义,根据Fagerstrom尼古丁依赖量表把吸烟组分成重度依赖组和轻度依赖组进一步分析,发现重度依赖组患者WCST正确反应数高于轻度依赖组(t=2.116,P=0.036)和非吸烟组(t=2.830,P=0.007),错误应答数低于轻度依赖组(t=-3.345,P=0.002)和非吸烟组(t=-3.513,P=0.001),后两组间差异无统计学意义;吸烟和非吸烟组在RBANS各项指标上差异均无统计学意义,进一步分组分析也未发现3组间在RBANS各项指标上的差异存在统计学意义。结论吸烟对精神分裂症患者的认知功能无明显影响,但在重度尼古丁依赖患者认知功能的改善明显好于轻度依赖及非吸烟患者。

Objective To explore the relationship between smoking behavior and cognitive function of male patients with chronic schizophrenia.Methods A total of 195 male inpatients who met the diagnostic criteria of schizophrenia according to Chinese Mental Disorders Classification and Diagnostic Criteria Version 3（CCMD-3）,121 cases in which were smoking,74 cases were not smoking,using inpatient tobacco use status questionnaire,nicotine dependence severity scale（FIND）to investigate patients＇ smoking status,their cognitive function were investigated with using the Wisconsin Card Sorting（WCST）and the repeatability of the neuropsychological status test（RBANS）.Results There were no significant differences in WCST various indicators between smoking group and non-smoking group of male patients with schizophrenia.According to Fagerstrom Nicotine Dependence Scale,smoking group was divided into severe dependence and mild dependent group,the severe dependent group（49.61±17.26）was higher in WCST number of correct responses than the mildly dependent group（42.26±14.35）and non-smoking group（41.79±13.52）（P0.05）,and was lower in number of error response（20.54±6.74）than the mildly dependent group（28.54±8.37）and non-smoking group（28.79±9.67）（P0.05）,there was no significant difference between the latter two groups;Smoking and non-smoking groups＇ RBANS indicators showed no significant differences.Further Subgroup analysis also found no statistically significant differences in RBANS indicators among three groups.Conclusion Smoking does not influence cognitive function of patients with schizophrenia,but improvement of cognitive function in severe nicotine dependence patients is significantly better than mildly dependent and non-smoking patients.