80例难治性精神分裂症的脑部CT分析与临床特征

The analysis on brain CT and clinical features of 80 cases of patients with treatment-resistant schizophrenia

目的分析80例难治性精神分裂症的脑部CT,了解脑部变化与精神分裂症发病的关系,探讨其临床特征。方法对2012年12月至2015年12月期间收治的80例难治性精神分裂症患者进行脑部CT扫描,与正常的80例体检人员的脑部CT结果作对比,同时通过明尼苏达多相人格调查表(MMPI)对患者进行相关精神分裂症状的研究。通过对CT检查结果研究脑萎缩患者与家族史、性别、性格、年龄的关系。结果 80例患者难治性精神分裂症患者共45例患者出现弥散性脑萎缩,分别为:皮质型19例、髓质型8例、皮、髓质混合型15例、小脑萎缩2例、1例两侧室旁核密度增大。患者MMPI评分中社会内向、精神衰弱、精神分裂、轻躁狂、偏执、病态人格、癔症、抑郁、疑病评分均超过50,精神症状严重。同时脑萎缩人数随年龄的增大而增加(P<0.05);分裂性格、偏执性格、外向性格的脑萎缩患者所占其性格比例无明显差异(P>0.05);脑萎缩患者在男女性别的比例无显著性差异(P>0.05)结论超过半数难治性精神分裂症患者出现不同类型的脑萎缩现象,脑萎缩与难治性精神分裂症有紧密的联系。

Objective To explore the relationship between the phrenia of patients with treatment-resistant schizophrenia. Methods changes of brain and the clinical feature schizo- 80 patients with treatment-resistant schizophre- nia in our hospital from December 2012 to December 2015 were selected as the observation group, while 80 cases of normal people as the control group, all the participants scanned brain CT. Investigated the symptoms of schizophrenia of patients by Minnesota Muhiphasic Personality Inventory （ MMPI ） . The relationship between clinical characters and the result of brain CT was studied. Results 45 cases of patients with treatment-resistant schizophrenia showed diffuse brain atrophy, included 19 cases of cortical type, 8 cases of medullary type, 15 cases of cortical and medullary type, 2 cases of cerebellar atrophy type and one case of increased nucleus density on both sides. The MMPI scores of patients all exceeded 50 at the aspect of social inward, athopia, split personality, hypomania, bigotry, hysteria, depression, hypochondriasis and their mental symptoms were serious. Meanwhile, the number of patients with brain atrophy increased with age （P 〈 0.05 ） . There was no significant difference in the proportion of the patients with brain atrophy in the personality such as schizoid personality, paranoid personality and outgoing personality （ P 〉 0.05 ） . Conclusion Brain atrophy of patients with treatment-resistant schizophrenia was closely related to clinical feature of disease.