老年精神分裂症一级亲属的认知功能及其影响因素研究

Research of cognitive function and influencing factors in first-degree relatives of elderly schizophrenia

目的探讨老年精神分裂症一级亲属的认知功能及其影响因素。方法 30例老年精神分裂症患者的健康子女(一级亲属组)、50例精神分裂症患者(患者组)、52名健康老年人(健康对照组)均接受简易智力状态检查(MMSE)、临床记忆量表(CMS)、威斯康星卡片分类测验(WCST)、连线测验(TMT-A)、数字符号(DSy)及数字广度(DSp)测验评估认知功能,采用多元逐步回归分析方法分析其影响因素。结果一级亲属组的MMSE总分、记忆商(MQ)、连线时间、DSy分、DSp分均显著高于患者组(P<0.05),其WCST各项成绩与患者组差异无统计学意义(P>0.05),其完成分类数、连线时间显著低于健康对照组(P<0.05)。受教育年限和BEAM均进入MMSE、持续反应数为因变量的回归方程,决定系数R2=0.276、0.422,生活事件、BEAM、个性、亲子关系、既往职业进入MQ为因变量的回归方程,R2=0.475。受教育年限与MMSE总分、MQ呈显著正相关(P<0.05),与持续反应数呈显著负相关(P<0.01);BEAM与持续反应数呈显著正相关(P<0.01);年龄与完成分类数呈显著负相关,与连线时间成显著正相关(P<0.05);生活事件、亲子关系与MQ呈显著负相关(P<0.05)。结论老年精神分裂症一级亲属存在明显的执行功能障碍,其影响因素主要包括受教育年限、BEAM和年龄。

Objective To investigate the cognitive function and its influencing factors in first-degree relatives of elderly schiz- ophrenia. Methods Totally 30 cases of healthy children with elderly patients with schizophrenia（a family group ）, 50 cases of patients with schizophrenia（patient group）, 52 healthy elderly subjects （health group） all accepeted mini-mental state examination （MMSE） ,clinical memory scale（CMS）, wisconsin card sorting test（WCST）, trail making test（TMT-A）, number sign（DSy） and digit span（DSp） tests. The influencing factors were analyzed by stepwise multiple regression analysis method. Results The MMSE score, MQ, connection time,DSy points, and DSp scores of kinship group were significantly higher in patients group（P〈0.05）. The accomplishments of its WCST of patient group was with no significant difference（P〉0.05）, and its completed categories, connection time was significantly lower than the normal group （P〈0. 05）. Years of education and BEAM were incorporated into the MMSE, the number of sustained response were the dependent variable regression equation, the coefficient of determination R^2 was 0. 276 and 0. 422, Life events,BEAM, personality, parent-child relationship, previous occupation MQ were the dependent variable into the regression equation,R; wa; 0. 475. Years of education and MMSE score,MQ were significant positive correlation（P〈0.05）, and sustained response were significantly negatively correlated（P〈0.01） ;BEAM and sustained response were significantly correlated（P〈0.01）;age and completed categories were significantly negatively, correlated and the connection time is significant positive correlation（P〈0.05） ;life events,parent-child relationship were significant negative correlation with MQ（P〈0.05）. Conclusion First-degree relatives of elderly schizophrenia have obvious executive dysfunction, the impact of factors including years of education, BEAM and age.