首次确诊精神分裂症患者认知功能损害情况分析

Study of Cognitive Function Impairment of Patients with First-diagnosed Schizophrenia

【目的】分析首次确诊精神分裂症患者的认知功能损害情况。【方法】选择2013年3月至2017年3月本院收治的92例首次确诊为精神分裂症且未经过治疗的患者作为研究对象，同时选择同期于本院体检的80例健康志愿者为对照组。采用成套认知功能评估工具（CANTAB）和改良版威斯康星卡片分类测验（M—WCST）评估两组认知功能，根据认知功能损害情况将研究组患者分为认知正常组和认知障碍组，采用阳性和阴性症状量表（PANSS）分析认知正常组和认知障碍组精神症状，比较其血清叶酸和同型半胱氨酸（Hcy）水平。【结果】观察组认知功能评估水平优于对照组，差异具有统计学意义（P〈0．05）；认知障碍组PANSS各症状评分及总分均显著高于认知正常组，差异具有统计学意义（P〈0．05）；认知障碍组血清叶酸水平为（4．21±1．53）ng／mL低于认知正常组的（7．62±1．94）ng／mL（P〈0．05），Hcy水平为（26．45±2．79）μmol／L高于认知正常组的（19．28±2．17）μmol／L，差异具有统计学意义（P〈0．05）。【结论】首次确诊精神分裂症患者认知功能较正常人群低，并且其精神病理症状、血清叶酸和Hcy水平与其认知受损程度具有一定的相关性。

[Objective]To analyze the cognitive function impairment of first-diagnosed schizophrenics. [Methods]From March 2013 to March 2017, 92 untreated schizophrenic patients were selected as the study subjects, and 80 healthy volunteers were selected as the control group. Cognitive function was assessed by a complete set of cognitive function assessment tools （CANTAB） and an improved Wisconsin card sorting test （M-WCST）. According to the cognitive impairment, the patients in the study group were divided into two groups： normal cognitive group and cognitive impairment group. The positive and negative symptom scale （PANSS） was used to analyze the mental symptoms in the normal cognitive group and the cognitive disorder group, and the serum folic acid and homocysteine （Hcy） levels were compared.[Results]The assessment level of cognitive function in the observation group was better than that of the control group （ P 〈0.05）, and the symptoms and total scores of PANSS in the cognitive impairment group were significantly higher than those in the cognitive normal group, and the difference was statistically significant （ P 〈0.05） ; the level of serum folic acid in the cognitive impairment group was （4.21 ± 1.53） ng/mL lower than that of the cognitive normal group （7.62 ± 1.94） ng/mL（ P 〈0.05）, the Hcy level was （26.45 ± 2.79） mol/L higher than that of the normal cognitive group （19.28± 2.17） mol/L, the difference was statistically significant （ P 〈0.05）.[ConclusionlThe cognitive function of the first diagnosed schizophrenic patients is lower than that of the normal subjects, and their psychopathological symptoms, serum folic acid and Hey levels are correlated with the degree of cognitive impairment.