利培酮对精神分裂症患者感觉门控P50缺陷的影响

目的探讨非典型抗精神病药物利培酮对精神分裂症患者感觉门控P50缺陷的影响。方法 26例急性期首发精神分裂症患者和25例急性期慢性精神分裂症患者入组,采用可变剂量（26 mg/d）的利培酮治疗,分别于治疗前及治疗46周后完成感觉门控P50测定。P50实验模式为听觉条件刺激（S1）-测试刺激（S2）模式。应用阳性与阴性症状量表（PANSS）评定精神症状,PANSS减分率评定疗效。结果治疗前P50测量指标在两组患者之间差异均无统计学意义（P〉0.05）,P50抑制指标与精神分裂症的病程、发作次数、精神症状（PANSS总分、阳性总分、阴性总分及一般精神病理分）之间均无相关性（P〉0.05）。治疗前后比较,除了S2波幅的组别主效应显著（P=0.02）外,其余P50测量指标的主效应及交互作用均不显著（P〉0.05）;利培酮对P50测量指标的影响与疗效无关。结论首发精神分裂症和慢性精神分裂症均存在感觉门控抑制缺陷。利培酮对首发和慢性精神分裂症的感觉门控P50抑制缺陷均无治疗改善作用。

P50 auditory sensory gating in first onset schizophrenics and normal healthy adults

The aim of this research was to investigate the variations of P50 auditory sensory gating(P50)in normal healthy adults and the first onset schizophrenics.By using the American Nicolet Bravo electromyography/evoked potential(EMG/EP)system,P50 was measured with conditioning-testing paradigm(paired-click stimuli S1 and S2 were used)in 58 first onset schizophrenics and 108 healthy adults,and the Positive and Negative Syndrome Scale(PANSS)was applied.The following three conclusions have been reached.(1)In normal control(NC)group,measured from central,anterior and posterior zone(Cz,Fz and Pz respectively),there were no statistical differences(P>0.05)between S1 and S2 evoked P50 peak latencies(S1-P50 and S2-P50);the ampli-tudes of S2-P50[(2.2P1.4),(2.3P1.5)and(2.1P1.4)μV respectively]reduced significantly as compared with S1-P50[(5.6P3.3),(5.6P3.9)and(4.9P2.8)μV respectively](P<0.01);the S2/S1 ration,S1-S2 difference,and 100(1-S2/S1)had no statistical differences(P>0.05).(2)Compared with NC,the schizophrenic group significantly showed lower S1-P50 amplitudes(P<0.01,except at Pz in whichZ=2.030,P=0.042),higher S2-P50 amplitudes,higher S2/S1 ratio,lower S1-S2 difference,and more decreased 100(1-S2/S1)(P<0.01)at Cz,Fz and Pz.(3)No significant correlations were found among S2/S1 ratio,S1-S2,100(1-S2/S1)of sen-sory gating and PANSS(P>0.05)in schizophrenic group.The first onset schizophrenics had sensory gating deficits,which could be quantified by P50.