儿童精神分裂症患者病前行为问题与病后脑室扩大的关系

The Association of Premorbid Abnormal Behavior and Ventricular Enlargement after Diagnosed the Disease in Childhood- onset Schizophrenia

目的：调查儿童精神分裂症患者病前行为问题与病后脑室扩大的关系。方法：选择92例儿童精神分裂症患者作为研究对象,采用Achenbach儿童行为量表（CBCL）,回顾性调查患者在4~5岁年龄段的行为特征。用行为问题总分的中位数将患者分为行为问题高分组和低分组,用CT测量患者的脑室参数。结果：儿童精神分裂症患者组CBCL社会能力总分（t=-2.690,P〈0.05）低于对照组;行为问题总分、抑郁因子分、社交退缩因子分、多动因子分及攻击性因子分（Z=-3.144,-3.370,-3.248,-2.862,-2.349;P〈0.05）均高于对照组,差异有统计学意义（P〈0.05）。行为问题总分高分组患者哈氏值及三脑室宽度（t=2.726,5.221;P〈0.05）均大于低分组患者,脑室指数及前角指数（t=-2.760,-2.166;P〈0.05）均小于低分组患者,差异有统计学意义（P〈0.05）。分裂强迫因子分与脑室指数（rs=-0.219,P=0.036）呈负相关,抑郁因子分与三脑室宽度呈正相关（rs=0.297,P=0.004）,社交退缩因子分与脑室指数（rs=-0.276,P=0.008）及前角指数（rs=-0.229,P=0.028）均呈负相关,多动因子分与前角指数（rs=-0.311,P=0.003）呈负相关,差异均有统计学意义（P〈0.05）。结论：儿童精神分裂症患者脑室扩大与病前行为问题存在相关关系,病前行为问题越多,病后脑室扩大和脑结构异常越明显。

Objective： To explore the relationship between premorbid abnormal behavior and ventricular enlargement after diagnosed the disease in childhood- onset schizophrenia（ COS）. Methods： 92 children with schizophrenia were recruited. They were retrospectively investigated with the Achenbach＇s Child Behavior Check- list（ CBCL） to evaluate their behavioral characteristics at the age from 4 to 5 years.Children with schizophrenia were divided into low score group and high score group according to median of behavioral problem total score in CBCL. Ventricular parameter were measured with cerebral computed tomography（ CT）. Results： Compared to healthy children controls,COS patients had lower total social competence score（ t =-2. 690,P 0. 05）; higher total behavioral problem score,depression factor,social withdrawal factor,hyperactivity factor,offensive factor scores（ Z =-3. 144,-3. 370,-3. 248,-2. 862,-2. 349; P 0. 05）; Compared to the patients with lower total behavioral problem scores,those with higher scores had larger Huckman value and width of third ventricle（ t = 2. 726,5. 221; P 0. 05）,smaller index of ventricle and index of anterior angle of ventricle（ t =-2. 760,-2. 166; P 0. 05）. Thought problems score was significantly inversely correlated with index of ventricle（ rs=-0. 219,P = 0. 036）,depression factor score was significantly positively correlated with width of third ventricle（ rs= 0. 297,P = 0. 004）,social withdrawn factor score was significantly inversely correlated with index of ventricle（ rs=-0. 276,P= 0. 008） and index of anterior angle of ventricle（ rs=-0. 229,P = 0. 028）,hyperactivity factor score was significantly inversely correlated with index of anterior angle of ventricle（ rs=-0. 311,P = 0. 003）.Conclusion： Premorbid abnormal behavior correlates with ventricular enlargement after diagnosed the disease,the more behavioral problems they have,the more obvious ventricle enlargement and brain structural abnormalities are.