老年精神分裂症患者脑电地形图与临床特征的相关性研究

Correlation research on brain electrical activity mapping and clinical features of elderly patients with schizophrenia

目的 探讨影响老年精神分裂症（SS）患者脑电地形图（BEAM）变异的主要因素.方法 选择重庆市精神卫生中心2012年1月～2013年3月治疗的SS患者50例（SS组）和健康老人（NC）52例（NC组）;均接受BEAM检查,并完成简易智力状态检查（MMSE）、日常生活能力量表（ADL）、简明精神病量表（BPRS）、社会功能缺陷筛选量表（SSDS）评定及一般资料的调查;采用多元逐步回归分析方法分析影响SS患者BEAM变异的相关因素.结果 ①SS组BEAM总体异常率与NC组比较差异无统计学意义（56.0％比42.3％,x2=0.961,P=0.327）;SS组除了右中央区θ波异常率显著高于NC组外（12.0％比1.9％,x2=4.050,P=0.044）,其他区域δ、θ波异常率与NC组比较差异均无统计学意义（P＞0.05）;SS组后颞部α1、α2波异常率均显著高于NC组（88.0％比67.3％,x2=6.249,P＜0.05;92.0％比76.0％,x2=6.281,P＜0.05）.②经单因素分析,SS组吸烟者BEAM异常率显著高于未吸烟者（x2=6.575,P=0.010）;余指标差异无统计学意义（P＞0.05）.③MMSE评分（t=-2.774,P=0.008）、APD剂量（t=2.993,P=0.005）、年龄（t=-2.180,P=0.035）、SDSS评分（f=2.236,P=0.031）、BPRS评分（t=-1.598,P=0.117）、ADL评分（t=-1.744,P=0.088）进入回归方程,决定系数R2=0.368.④经Pearson相关分析,BEAM与APD剂量（r=0.345,P=0.014）、SDSS评分（r=0.291,P=0.040）显著正相关.结论 影响SS患者BEAM变异的主要因素包括认知功能、药物剂量、年龄及社会功能,改善脑功能应重点从这几个方面进行考虑.

Objective To investigate the main factors that affect the brain electrical activity mapping （BEAM） in senile schizophrenia （SS） patients.Methods 50 patients with SS （SS group） and 52 cases of normal control （NC） （NC group） in Chongqing Mental Health Center from January 2012 to March 2013 were selected.All the patients were checked by BEAM; MMSE,ADL,BPRS,SSDS scale assessment and general information surveys were used to evaluate; multiple stepwise regression analysis method was used to analyze the BEAM mutation related factors of SS patients.Results ①The difference of overall abnormal rate of BEAM in the two groups was not statistically significant （56.0％ vs 42.3％,x2 =0.961,P =0.327）; the difference of δ,θ wave abnormal rate between SS group and NC group was not statistically significant （P ＞ 0.05） except that the right central zone θ wave abnormal rate in SS group was higher than that in NC group （12.0％ vs 1.9％,x2 =4.050,P =0.044）; retral tempus area α1,α2 wave abnormal rate in SS group were higher than those in NC group （88.0％ vs 67.3％,x2 =6.249,P ＜ 0.05; 92.0％ vs 76.0％,x2 =6.281,P ＜ 0.05）.②BEAM abnormal rate of smokers was higher than that of non-smokers in SS group （x2 =6.575,P =0.010）; the difference of BEAM abnormal rate of other indexes in SS group was not statistically significant （P ＞ 0.05）.③MMSE score （t =-2.774,P =0.008）,APD dose （t =2.993,P =0.005）,the age （t =-2.180,P =0.035）,SDSS score （t =2.236,P =0.031）,BPRS score （t =-1.598,P =0.117）,ADL score （t =-1.744,P =0.088） were found in the regression equation,the coefficient of determination was R2 =0.368.④The positive correlation was found among APD dose （r =0.345,P =0.014）,SDSS score （r =0.291,P =0.040） and BEAM according to the Pearson correlation analysis.Conclusion The main factors influencing the SS patients BEAM mutation include cognitive function,drug dosage,age and social function.It is right to take the factors into consideration in order to improve brain function.