男性首发精神分裂症患者病前吸烟、精神病未治疗时间及认知功能的关系

Relationship among smoking before disease, duration of untreated psychosis and the cognitive function in male first-episode schizophrenic patients

目的探讨男性首发精神分裂症患者病前吸烟与精神病未治疗时间(DUP)及认知功能的关系。方法选取2016年5月-2018年7月在杭州市第七人民医院就诊的86例首发精神分裂症未用药患者,使用SOS量表确定DUP,根据DUP中位值分为短DUP组(39例)和长DUP组(47例),调查患者开始吸烟年龄、吸烟年限、吸烟量,采用尼古丁依赖严重程度量表(FTND)评定吸烟严重程度,WCST、P300测定认知功能,并与40例正常对照比较。采用χ^2检验、t检验、方差分析比较患者吸烟情况及认知功能的差异,相关分析分析吸烟情况与DUP、认知功能的相关性。结果①长、短DUP患者组吸烟年龄早于对照组(均P<0.001),烟量均高于对照组(均P<0.05),FTND评分均高于对照组(均P<0.05);与短DUP组相比,长DUP组的吸烟量、FTND均较高(均P<0.05);长、短DUP患者吸烟率均高于对照组(均P<0.05),长DUP组吸烟率高于短DUP组(P<0.05);②2组患者WCST各因子及P300潜伏期与波幅与对照组差异均有统计学意义(均P<0.001);与短DUP组相比,长DUP组除在分类完成数、P300潜伏期差异无统计学意义(均P>0.05),其他认知功能差异均有统计学意义(均P<0.05);③所有患者中,吸烟年龄与DUP、总测验数呈负相关(r=-0.256、-0.224,均P<0.05)、与波幅呈正相关(r=0.274,P=0.011);吸烟年数与潜伏期呈正相关(r=0.225,P=0.037);吸烟量、FTND评分与DUP呈正相关(r=-0.739、0.720,均P<0.001);FTND评分与正确数呈负相关(r=-0.271,P=0.012)。结论病前吸烟是精神分裂症发病的危险因素之一,有可能延长DUP,并最终引起认知功能下降。

Objective To explore the relationship among smoking before disease, duration of untreated psychosis(DUP) and the cognitive function in male first-episode schizophrenic patients. Methods A total of eighty-six first episode patients were divided by DUP into short DUP group(n=39) and long DUP group(n=47). Investigate the age at starting smoking, smoking years and smoking amount, the FTND, WCST and P300 were used to evaluate smoking severity and cognitive function and contrasted with 40 health controls. Chi-squared Test, t-test and ANOVA was used to analyze the data. The Pearson correlation analysis was used to analyze the correlation between smoking behavior and cognitive function. Results ①Comparing with controls, the age at smoking in two patient groups were earlier(each P<0.001), smoking amount were higher(each P<0.05), the scores were higher(each P<0.05), and the rate of smoking were higher(each P<0.05). Comparing with short DUP group, smoking amount and scores of FTND were higher(each P<0.05), and the rate of smoking were higher(P<0.05).②Comparing with controls, there were significantly differences in two patient groups in cognitive function(each P<0.001), and there were significantly difference between two patient groups in cognitive function(each P<0.05) except classification completion number of WCST and latency of P300(each P>0.05).③In all patients, the age at start smoking were negatively correlated with the DUP and total number of tests in WCST(r=-0.256,-0.224, each P<0.05), and positively correlated with amplitude of P300(r=0.274, P=0.011);smoking years was positively correlated with latency of P300(r=0.225, P=0.037);smoking amount and FTND score were positively correlated with DUP(r=-0.739, 0.720, each P<0.001);FTND score was positively correlated with the Correct Number(r=-0.271, P=0.012). Conclusion Smoking before disease is a risk factor for schizophrenia, which may prolong DUP and eventually lead to cognitive decline.