首发和慢性精神分裂症患者神经认知功能的性别差异

Sex differences in cognitive impairments in first-episode and chronically schizophrenic patients

目的探讨首发未服药精神分裂症(FES)和慢性精神分裂症(CSz)患者的神经认知功能的性别差异。方法收集符合ICD-10的FES患者53例和CSz患者104例,同期募集健康对照(HC)52名。3组均采用MATRICS共识认知成套测验(MCCB)中文版评估神经认知功能。结果(1)MCCB测验得分性别差异比较结果显示,组别和性别的交互作用无统计学意义(F=0.80,P=0.67);组别的主效应显著,MCCB6项分测验及神经认知总分差异均有统计学意义;性别的主效应在视觉学习记忆分测验差异有统计学意义(F=5.12,P=0.03)。CSz组视觉学习记忆女性优于男性(t=2.44,P=0.02),FES组和HC组性别差异无统计学意义。(2)与HC组比较,除词语学习和记忆外,FES和CSz组MCCB总分和各分测验评分比较差异均有统计学意义。FES与CSz组比较,FES组在神经认知维度总分优于CSz组(t=2.36,P=0.05)。结论首发和慢性精神分裂症患者的认知功能均受损,且男性慢性患者视觉学习记忆损害较女性更为严重。

Objectives To investigate the sex differences in neurocognitive function in patients with first-episode schizophrenia (FES) and chronic schizophrenia (CSz). Methods A total of 53 patients with FES and 104 patients with CSz were enrolled, and 52 healthy controls (HC) were recruited at the same time. The three groups were evaluated for neurocognitive function using the Chinese version of the MATRICS Consensus Cognitive Battery (MCCB). Results (1) The comparison of sex differences in MCCB test scores showed that the interaction between groups and sexes was not statistically significant (F=0.80, P=0.67);the main effects of the group were significant, and the scores of 6 MCCB subtests and the total neurocognitive scores were all significantly different;the main effect of gender was statistically significant in the visual learning memory test (t=5.12, P=0.03). The females in the CSz group were better than the males in visual learning memory t=2.44, P=0.02);There was no significant difference between sexes in the FES and the HC group.(2) Compared with the HC group, the scores of the MCCB total scores and the scores of the subtests in the FES and CSz groups were all statistically different, except for vocabulary learning and memory. Compared with the CSz group, the total score of the neurocognitive dimension in the FES group was better (t=2.36, P=0.05). Conclusions The cognitive function of both the first-episode and chronic schizophrenia patients is impaired and the visual learning and memory impairment in male chronic patients are more serious than in female patients.