稳定期双相障碍I型患者认知功能及其相关因素研究

Cognitive function and related factors in patients with bipolar I disorder in stationary phase

目的 探讨稳定期双相障碍Ⅰ型患者认知功能损害及其相关因素.方法 纳入108例稳定期双相障碍Ⅰ型患者（患者组）和108名正常对照者（正常对照组）.分别采用数字符号、数字广度（顺背、倒背、总分）、连线测验A （TMT-A）、连线测验B（TMT-B）和威斯康星卡片分类测验（WCST）评定受试者.结果 （1）患者组数字符号、数字广度（顺背、倒背、总分）、TMT-A、TMT-B和WSCT（总错误数和持续错误数）成绩均差于正常对照组（P＜O.05,P＜0.01）.（2）按有（n=50）和无（n=58）精神病性症状将患者组进一步分层分析,方差分析显示组间差异有统计学意义（P＜0.01）,经LSD检验显示,有精神病性症状组的上述指标均较正常对照组差（P＜0.01）,而无精神病性症状组除数字广度（顺背）外,余各指标均较正常对照组差（P ＜0.05,P＜0.01）.（3）相关分析显示,患者组数字符号、数字广度（倒背、总分）、TMT-A和TMT-B均与汉密尔顿抑郁量表（HAMD）和Young躁狂量表（YMRS）评分相关（｜r｜ =0.20～0.46,P＜0.05,P＜0.01）,未发现发病年龄和稳定时间与任何认知功能指标相关（P＞0.05）.结论 稳定期双相障碍Ⅰ型患者存在明显的注意、记忆和执行功能损害,并与临床症状等临床特征相关.

Objective To examine the impairment of cognitive function and its related factors in patients with bipolar I disorder （BD-I） in stationary phase. Methods 108 cases with BD-I in stationary phase （study group） and 108 healthy controls （control group） were assessed with digit symbol, digit span, trail making test-A （TMT-A） making test - B （TMT-B） and Wisconsin Card Sorting Test （WSCT）. Results （ 1 ） The performance of digit symbol, digit span, TMT-A, TMT-B and WCST in study group were significantly worse than those in control group （ P 〈 0.05 or P 〈 0.01 ）. （2） BD-I patients were divided into subgroups with （ n = 50） and without （ n = 58 ） psychotic symptoms, and there were significant differences in performance of digit symbol, digit span, TMT-A, TMT - B and WCST between the two subgroups （P 〈 0.01 ）. LSD test indicated that parameters mentioned above in the two subgroups other than the digit span in subgroup without psychiatric symptoms were significantly worse than those in control group （P 〈 0.05 or P 〈0.01 ）. （3） In study group, score of HAMD or YMRS were symbol, digit span, TMT-A and TMT-B （ I r I --- 0.20 ~ 0.46, correlation between age of onset, length of stationary phase and Conclusion Cognitive function such as attention, memory and stationary phase, which are correlated with clinical features. significantly correlated with the performance of digit P 〈 0.05 or P 〈 0.01 ）. There was no significant the performance of cognitive function （ P 〉 0.05 ）. executive function are impaired in BD-I patients in