首发未经治疗精神分裂症患者认知功能及其影响因素

Cognitive function and related factors in patients with the first-episode schizophrenia

目的了解首发未经治疗精神分裂症患者认知功能及其影响因素,为精神分裂症的治疗提供依据。方法对34例首发未经治疗精神分裂症患者(患者组)及33例健康者(对照组)进行数字符号编码测验(symbol coding)、符号搜索测验(symbol search)、连线测验(trail making test,TMT)、色字词测验(stroop test)、韦氏记忆测验(Wechsler memory scale,WMS)、改良版的威斯康辛卡片分类测验(Wisconsin card sorting test,WCST),评定认知功能,使用阳性与阴性症状量表(PANSS)评定临床症状。结果患者组的部分认知测验成绩与受教育年限呈正相关,与病程呈负相关,而与年龄无关。男性精神分裂症患者WMS中的再认测验成绩及Stroop测验中的色词干扰测验成绩明显差于女性患者,差异有统计学意义(P<0.05),但在完成连线测验A时出现的错误数(0.25±0.78)却明显少于女性患者(1.07±1.43),差异有统计学意义(P<0.05)。患者组WMS中的再生测验成绩与PANSS阴性分呈负相关(r=-0.408,P<0.05),Stroop-字得分与PANSS阴性分呈负相关(r=-0.355,P<0.05),Stroop-字与Stroop-色词差异分数与PANSS阴性分呈负相关(r=-0.380,P<0.05)。结论精神分裂症患者认知功能损害可能受性别、受教育年限和病程等因素影响,精神分裂症认知功能损害与阴性症状密切相关。

Objective To explore the cognitive function and related factors in the first-episode schizophrenia. Methods Thirty four patients with the first-episode schizophrenia and 33 healthy controls were assessed by a battery of neuropsychological tests, which included trail making test, stroop test, symbol coding, symbol search, Wisconsin card sorting test, Wechsler memory scale, and the clinical symptoms were evaluated with Positive and Negative Syndrome Scale （PANSS）. Results The cognition of the acute schizophrenia may be affected by gender, educational level. The scores of the stroop test and the recognition component of WMS of male patients were significantly lower than those of female patients （P〈0.05）. In TMT-A, the errors number （0.25±0.78） of male patients was much less than that of female patients （1.07±1.43） （P〈0.05）. In WMS, the scores of the recognition component were negatively correlated to the negative scores of psychotic symptoms （r=-0.408,P〈0.05）. Also, in stroop test, the scores of Stroop-word and the discrepancy scores of Stroop-word minus Stroop-color and word were negatively correlated to the negative scores of psychotic symptoms （r=-0.355 ,P〈0.05; r=-0.380,P〈0.05）. Conclusion Cognitive dysfunction in patients with first- episode schizophrenia may be affected by gender, educational level and illness duration and negative symptoms.