急性期精神分裂症脑影像异常者临床特征分析

Analysis of clinical characteristics of acute schizophrenia with abnormal brain imaging

目的分析急性期精神分裂症头部磁共振结构异常者的相关临床特征。方法回顾性分析首都医科大学附属北京安定医院在2017年1月至2018年12月期间住院的470例急性期精神分裂症患者的头部磁共振影像学资料,依据脑影像有无改变分为研究组204例(头部MRI异常者)、对照组266例(头部MRI正常者),比较两组患者的临床特征差异。结果急性期精神分裂症脑影像异常者204例,其检出率为43.4%。与对照组相比,研究组患者的阳性家族史(32.8%vs.20.7%,χ^2=8.89)、围生期异常(18.6%vs.8.3%,χ^2=11.12)、性格内向孤僻(74.0%vs.65.0%,χ^2=4.35)、伴有冲动攻击行为(49.0%vs.28.9%,χ^2=19.81)更常见,差异均具有统计学意义(P<0.01)。Logistic回归性分析显示,脑影像异常者的危险因素为围生期异常(OR=2.54,95%CI:1.42~4.53),冲动攻击行为(OR=2.38,95%CI:1.61~3.52),阳性家族史(OR=1.88,95%CI:1.22~2.90)(P<0.01)。结论急性期精神分裂症脑影像异常检出率高,急性期精神分裂症脑影像异常者存在围生期异常、阳性家族史、冲动攻击行为的风险更高。

Objective To analyze the clinical characteristics of acute schizophrenia with abnormal brain magnetic resonance imaging(MRI).Methods A retrospective analysis of the brain MRI data of 470 patients with acute schizophrenia in Beijing Anding Hospital,Capital Medical University from January 2017 to December 2018.According to brain imaging abnormalities,204 patients were divided into the study group(with abnormal brain MRI)and 266 patients in the control group(with normal brain MRI),and the differences of clinical features between the two groups were compared.Results 204 patients with abnormal brain MRI of acute schizophrenia,the abnormal detection rate was 43.4%.Compared with control group,study group had significantly positive family history(32.8%vs.20.7%,χ^2=8.89),more abnormal perinatal period(18.6%vs.8.3%,χ^2=11.12),more introverted personality(74.0%vs.65.0%,χ^2=4.35),and more impulsive aggressive behavior(49.0%vs 28.9%,χ^2=19.81),the differences were statistically significant(P<0.01).Logistic regression analysis showed that abnormal brain structure was positively correlated with abnormal perinatal period(OR=2.54,95%CI:1.42-4.53),positive family history(OR=1.88,95%CI:1.22-2.90),impulsive aggressive behavior(OR=2.38,95%CI:1.61-3.52)(P<0.01).Conclusion The prevalence of abnormal brain imaging in acute schizophrenia is high,and the risk of perinatal abnormality,positive family history and impulsive aggressive behavior is higher in schizophrenia with abnormal brain imaging.