首发精神分裂症患者及不同样本健康一级亲属的认知功能研究

Cognitive functions in first-episode schizophrenia and unaffected first-degree relatives of different patients

目的 探讨首发精神分裂症患者及不同样本首发精神分裂症患者健康一级亲属的认知功能特点.方法 对52例首次发作未接受过抗精神病药物治疗的精神分裂症患者（患者组）、48例不同样本来自不同于患者组的另一组首发精神分裂症的健康一级亲属（亲属组）及50例健康志愿者（对照组）,采用数字划销测验、连线测验、数字广度测验、视觉再生、言语流畅性测验、威斯康辛卡片分类测验和汉诺塔测验评定注意、记忆及执行功能.结果 三组间数字划销测验净分、连线测验A时间及B时间、数字广度倒背及总分、视觉再生总分、言语流畅性音位及语义、威斯康辛卡片分类测验（WCST）总错误数及持续错误数、汉诺塔测验所有指标的差异有统计学意义（P ＜0.05或P＜0.01）.两两比较发现,患者组的上述所有指标和亲属组除连线测验A时间外的上述指标均差于对照组（P ＜0.05或P＜0.01）,但亲属组数字划销测验净分、连线测验A时间及B时间、视觉再生总分、言语流畅性音位及语义、WCST总错误数及持续错误数的成绩要好于患者组（P＜0.05或P＜0.01）.结论 首发精神分裂症患者存在广泛的认知功能损害,且来自不同家族的健康一级亲属也存在不同程度的认知功能损害,提示认知功能受损可能是精神分裂症遗传易感性的生物学指标.

Objective To investigate cognitive functions in first-episode schizophrenia and unaffected first-degree relatives of different patients.Methods A total of 52 patients with first-episode schizophrenia （patient group）,48 unaffected first-degree relatives of different patients （relatives group） and 50 healthy normal controls （control group） was recruited in the study.The attention,memory,and executive functions of all the subjects were assessed by a battery of neuropsychological tests,including cancellation test （CT）,trail making test （TMT）,digit span （DS）,visual reproduction （VR）,verbal fluency task （VFK）,Wisconsin card sorting test （WCST） and HANOI tower.Results There were statistically significant difference among three groups in net scores of CT,TMTA,TMT-B,backward and total scores of DS,scores of VR,VFK,total errors and perseverate errors of WCST and all indicators of HANOI Tower （P ＜0.05 or P ＜ 0.01）.Post Hoc multiple comparisons showed that,compared with the control group,the patient group had worse scores in all tests above except TMT-A in the relatives group （P ＜0.05 orP ＜0.01）.However,compared with the patient group,the relatives group had better scores in net scores of CT,TMT-A,TMT-B,scores of VR,VFK,total errors and perseverate errors of WCST （P ＜ 0.05 or P ＜ 0.01）.Conclusions Patients with first-episode schizophrenia have global cognitive functions deficits.Unaffected first-degree relatives of different patients also have cognitive deficits to a certain extent.Our study indicates that cognitive functions deficits may be viewed as a biomarker for candidates reflecting genetic liability for schizophrenia.