精神病超高危人群及精神分裂症一级亲属的认知功能研究

Cognitive function in ultra high-risk subjects and first degree relatives with schizophrenia

目的探讨精神病超高危人群和一级亲属中认知功能损害的特点。方法采用精神分裂症认知功能成套测验一共识版中的连线测验、符号编码、霍普金斯词语学习测验修订版、简易视觉记忆测验修订版、持续操作测验和Stroop色词测验对精神病超高危人群（超高危组）、精神分裂症患者一级亲属（一级亲属组）和健康对照者（对照组）进行认知功能评定，每组30例。采用SPSS17．0对各组间数据进行差异性分析。结果（1）超高危组与对照组比较，在符号编码（t=-4．191，P〈0．01）、霍普金斯词语学习（t=O．754，P=O．005）、持续操作（t=3．780，P=O．001）、Stroop色词（Stroop单词t=-4．073，P〈0．01；Stroop颜色t=-2．033，P-O．047；Stroop色词t=-3．609，P=O．001）测验中，差异均有统计学意义；（2）一级亲属组与对照组比较，在符号编码（t=-2．247，P=0．028）、霍普金斯词语学习（t=-2．038，P=0．046）、简易视觉记忆（t=-2．209，P=0．031）、持续操作（t=-2．687，P=0．011）、Stroop色词（Stroop单词t=-4．655，P〈O．01；Stroop色词t=2．341，P=O．023）测验中，差异具有统计学意义；（3）在符号编码测验中，超高危组[（43．9±10．7）分]比一级亲属组[（50．1±11-3）分]评分低，差异有统计学意义（t=-2．188，P=0．033）；（4）超高危组中，同时符合遗传风险和功能衰退精神病风险综合征以及轻微阳性症状精神病风险综合征诊断标准的个体（n=8）和只符合遗传风险和功能衰退精神病风险综合征诊断标准的个体（n=9）间，各认知测验分数差异无统计学意义。结论在精神病超高危人群和精神分裂症一级亲属中已存在广泛的认知功能损害，涉及信息处理速度、言语学习和记忆、工作记忆、注意膳觉等方面，超高危人群在信息处理速度方面比一级亲属差。

Objective To explore the characteristics of cognitive impariment in ultra high-risk subjects and familial high risk group with schizophrenia. Methods The cognitive function was assessed by the Trail Marking Test, Symbol Coding（SC）, Hopkins Verbal Learning Test- Revised （HVLT-R）, Brief Visual spatial Memory Test-Revised（BVMT-R）, Continuous Performance Test （CPT） from MATRICS Consensus Cognitive Battery, and Stroop Test in ultra high-risk （UHR） group, unaffected first-degree relatives （FDR） group and health control （HC） group, and 30 cases in each group. The difference among groups was analyzed by SPSS17.0 soft. Results （1）The SC（t=-4.191, P〈0.01）, HVLT-R（t=0.754, P=0.005）,CFF（t=-3.780, P= 0.001 ） and Stroop （Stroop words t=-4.073, P〈0.01, Stroop color t=-2.033, P=0.047, Stroop color words t=-3.609, P=0.001） test scores between the UHR and HC groups showed significant differences. （2）SC （t=- 2.247, P=0.028）, HVLT-R （t=- 2.038, P=0.046）, BVMT-R （t=- 2.209, P=0.031 ）, CPT （t=- 2.687, P= 0.011） and Stroop （Stroop words t=-4.655, P〈0.01, Stroop color words t=-2.341, P=0.023）test scores between the FDR and HC groups showed significant differences. （3）UHR group （43.9±10.7） showed lower scores than FDR group （50.1± 11.3） in the SC test, and it showed significant difference （t=-2.188, P=0.033 ）.（4）In the UHR group, there were no significant differences for the cognitive function between the subjects with genetic risk met the criteria for genetic risk and deterioration psychosis-risk syndrome and attenuated positive symptom psychosis-risk syndrome （n=8） and the subjects with pure genetic risk and deterioration psychosis-risk syndrome （rt=9）. Conclusions Cognitive impairment appeares in the UHR and FDR populations, including the information-processing speed, verbal learning, working memory, attention/vigilance and so on. The UHR subjects present worse in information-proeessing speed.