稳定期双相障碍患者认知功能损害特点及相关因素分析

Analysis of characteristics and related factors of cognitive impairment in patients with bipolar disorder in stationary phase

目的：探讨双相障碍稳定期患者认知功能损害的特点及其相关因素。方法选取在我院接受治疗的稳定期双相障碍患者105例作为患者组，选取103例健康体检者作为健康对照组。采用数字符号测验、数字广度测验、连线测验（TMT）A和B及威斯康星卡片分类测验（WCST）对受试者的认知功能进行评定。结果患者组的数字符号测验、数字广度测验、TMT －A、TMT －B、WSCT测验成绩均显著低于健康对照组，差异有统计学意义（P ＜0．05）；将患者组分为有精神病症状组和无精神病症状组，通过方差分析，显示三组之间各项测验成绩的差异均有统计学意义（P＜0．05），进一步进行LSD检验，结果显示有精神病症状组上述指标均比健康对照组差，差异有统计学意义（P＜0．05），无精神病症状组除数字广度测验（顺背）外，其余各项指标均比健康对照组差（P＜0．05）；进行相关性分析发现，患者组的数字符号测验、数字广度测验（倒背、总分）、TMT －A、TMT －B成绩与患者的汉密尔顿抑郁量表（HAMD）和Young氏躁狂量表（YMRS）评分之间具有相关性（P ＜0．05），患者的发病年龄、稳定时间和认知功能评分之间无相关性（P ＞0．05）。结论稳定期双相障碍患者存在注意力、记忆力和执行功能损害，其认知功能与 HAMD、YMRS评分存在一定的相关性。

Objective To explore the characteristics and related factors of cognitive impairment in patients with bipolar disorder（BD） in stationary phase .Methods A total of 105 cases with BD in station‐ary phase （patient group） and 100 healthy controls （control group） were assessed with digit symbol , digit span ,Trail Making Test -A （TMT -A） ,Trail Making Test-B （TMT -B） and Wisconsin Card Sorting Test （WSCT） .Results The performance of digit symbol ,digit span ,TMT -A ,TMT -B and WCST in patient group were significantly worse than those in control group （P 〈 0 .05）;BD patients were divided into subgroups with and without psychotic symptoms ,and there were significant differences in the performance of digit symbol ,digit span ,TMT -A ,TMT -B and WCST between the two sub‐groups （P〈 0 .05） .LSD test indicated that parameters mentioned above in the two subgroups other than the digit span in subgroup without psychiatric symptoms were significantly worse than those in control group （P 〈 0 .05） .In patient group ,the scores of HAMD or YMRS were significantly correlated with the performance of digit symbol ,digit span ,TMT -A and TMT -B （P〈 0 .05） .There was no signifi‐cant correlation between age of onset ,length of stationary phase and the performance of cognitive func‐tion （P 〉 0 .05） .Conclusions Cognitive function such as attention ,memory and executive function are impaired in BD patients in stationary phase ;there may be some correlations between the HAMD ,YMRS score and cognitive function .