精神分裂癥患者一級親屬及首發(fā)患者認知功能的對照研究
發(fā)布時間：2018-10-11 09:13
【摘要】：背景精神分裂癥是一組病因不明確的常見重性精神病,關于精神分裂癥的發(fā)病因素和機制,目前存在爭論,但在家族遺傳、分子遺傳等方面的研究均發(fā)現(xiàn)該類疾病有顯著的遺傳特征,遺傳因素在精神分裂癥發(fā)病中如何發(fā)揮作用,也尚無定論;精神分裂癥患者認知功能的損害造成其社會功能的恢復困難也是目前臨床治療過程中瓶頸問題;深入探討精神分裂癥患者的認知損害特點,綜合各種治療方法幫助該類疾病患者恢復認知具有十分重要的現(xiàn)實意義。目的1.首發(fā)精神分裂癥患者、精神分裂癥患者的一級親屬、正常對照組間認知功能的差異;2.首發(fā)精神分裂癥患者在有無精神病家族史方面認知功能的差異;3.首發(fā)精神分裂癥患者在應用非典型抗精神病藥物治療前后認知功能的差異,本研究首發(fā)組均使用利培酮治療,通過上述研究,以期尋找出患者及其家族成員遺傳異質(zhì)性的內(nèi)在特點,從而對于該病的發(fā)生提前做一些有效的干預工作。方法將首發(fā)精神分裂癥患者、精神分裂癥患者的一級親屬、健康志愿者分別選取60名入組,即首發(fā)患者組、一級親屬組和正常組,癥狀評定由10名精神科主治醫(yī)師完成,他們?nèi)拷?jīng)過統(tǒng)一的標準化培訓;認知功能評定工具采用精神分裂癥認知療效評定的測量工具—精神分裂癥認知功能成套測驗-共識版(MCCB),包括連線測試、Stroop色詞測驗在內(nèi)共六項,由2名專業(yè)培訓的精神科副主任醫(yī)師完成,患者組在治療前后需要評定陽性、陰性精神癥狀,采用PANSS評分,最后應用SPSS 24.00進行數(shù)據(jù)處理。結果1首發(fā)精神分裂癥患者的各項MCCB神經(jīng)心理測驗成績與正常對照組均有顯著差異,P均㩳0.01,具有統(tǒng)計意義;精神分裂癥一級親屬組的連線測試、符號編碼、HVLT-R、Stroop色詞測驗的顏色、色詞成績與對照組有顯著差異,P均㩳0.01,具有統(tǒng)計意義,Stroop色詞測驗的單詞成績、持續(xù)操作測驗(CPT)各項結果與對照組比較有差異,P均㩳0.05,具有統(tǒng)計學意義,其他MCCB結果與正常對照組比較,無統(tǒng)計意義。2有陽性家族史的首發(fā)組與無陽性家族史的首發(fā)組的符號編碼、HVLT-R(總分、T3)、CPT-IP(總分、2D)、Stroop色詞測驗單詞成績比較差異較明顯,P均㩳0.01,表示兩組樣本之間具有有顯著的差異。3首發(fā)精神分裂癥患者在治療前后的神經(jīng)心理測驗結果比較除HVLT-R總分、TI、T2、T3、BVMT-R(T1)無差異外,P㧐0.05,其余各項如連線測試、Stroop色詞測驗等其余各項指標均顯著差異,P㩳0.01,有統(tǒng)計學意義;治療前后首發(fā)組PANSS評分中陽性癥狀、陰性癥狀及一般病理對照差異顯著,P㩳0.01,均有統(tǒng)計意義。結論1.認知功能損害普遍出現(xiàn)在首發(fā)精神分裂癥患者當中。2.精神分裂癥患者的一級親屬已經(jīng)出現(xiàn)處理速度與注意警覺、言語記憶等方面認知功能損害。3.有陽性家族史的首發(fā)精神分裂癥患者在注意警覺、詞語學習記憶、工作記憶等方面存在顯著的缺陷。4.首發(fā)精神分裂癥患者經(jīng)過藥物治療后認知功能可得到改善,處理速度、工作記憶、注意警覺恢復的比較顯著。
[Abstract]:Background schizophrenia is a group of common serious psychoses with unclear etiology, and there is an argument about the pathogenesis and mechanism of schizophrenia, but studies on family heredity, molecular genetics and so on have found that these diseases have significant genetic characteristics. The genetic factors play a role in the pathogenesis of schizophrenia, and there is no definite conclusion; the impairment of cognitive function in the patients with schizophrenia is the bottleneck problem in the current clinical treatment process; the cognitive impairment characteristics of the patients with schizophrenia are discussed in detail. It is of great practical significance to synthesize various treatment methods to help patients with these diseases recover their cognition. Purpose 1. The difference of cognitive function among patients with first-episode schizophrenia, first-degree relatives of schizophrenia and normal control group; 2. Differences in cognitive function in patients with first-episode schizophrenia in the absence of family history of mental illness; 3. The difference of cognitive function before and after the treatment of atypical antipsychotics was used in the first episode of schizophrenia, and the first group was treated with Lepione, with a view to finding the intrinsic characteristics of genetic heterogeneity among patients and their families. so as to do some effective interventions for the occurrence of the disease. Methods Sixty patients with schizophrenia, first-order relatives and healthy volunteers were selected from 60 enrolled patients, namely, the first group, the first-level relatives group and the normal group. The cognitive function assessment tool used the cognitive function complete test-consensus version (MCCB) of the schizophrenia cognitive function evaluation tool, including the connection test, the pop-up color word test, six in total, and the two professional trained psychiatrist completed the test. The patient group needs to evaluate the positive and negative mental symptoms before and after treatment, the PANSS score is adopted, and the data processing is finally carried out by SPSS 24.00. Results There were significant differences between the MCCB neuropsychological test scores and the normal control group in the first episode of schizophrenia. 0. 01, with statistical significance; connection test, symbol coding, HVLT-R, Sop color word test of relatives group at the first level of schizophrenia, with significant difference in color word score and control group, all P? 0. 01, with statistical significance, the results of continuous operation test (CPT) were different from those in the control group, all of which were different from those in the control group. 0. 05, with statistical significance, the results of other MCCB were not statistically significant compared with the normal control group. There was no statistical significance. There was a significant difference between the first group of positive family history and the initial group without positive family history, HVLT-R (total score, T3), CPT-IP (total score, 2D). P鍧，
本文編號：2263649
[Abstract]:Background schizophrenia is a group of common serious psychoses with unclear etiology, and there is an argument about the pathogenesis and mechanism of schizophrenia, but studies on family heredity, molecular genetics and so on have found that these diseases have significant genetic characteristics. The genetic factors play a role in the pathogenesis of schizophrenia, and there is no definite conclusion; the impairment of cognitive function in the patients with schizophrenia is the bottleneck problem in the current clinical treatment process; the cognitive impairment characteristics of the patients with schizophrenia are discussed in detail. It is of great practical significance to synthesize various treatment methods to help patients with these diseases recover their cognition. Purpose 1. The difference of cognitive function among patients with first-episode schizophrenia, first-degree relatives of schizophrenia and normal control group; 2. Differences in cognitive function in patients with first-episode schizophrenia in the absence of family history of mental illness; 3. The difference of cognitive function before and after the treatment of atypical antipsychotics was used in the first episode of schizophrenia, and the first group was treated with Lepione, with a view to finding the intrinsic characteristics of genetic heterogeneity among patients and their families. so as to do some effective interventions for the occurrence of the disease. Methods Sixty patients with schizophrenia, first-order relatives and healthy volunteers were selected from 60 enrolled patients, namely, the first group, the first-level relatives group and the normal group. The cognitive function assessment tool used the cognitive function complete test-consensus version (MCCB) of the schizophrenia cognitive function evaluation tool, including the connection test, the pop-up color word test, six in total, and the two professional trained psychiatrist completed the test. The patient group needs to evaluate the positive and negative mental symptoms before and after treatment, the PANSS score is adopted, and the data processing is finally carried out by SPSS 24.00. Results There were significant differences between the MCCB neuropsychological test scores and the normal control group in the first episode of schizophrenia. 0. 01, with statistical significance; connection test, symbol coding, HVLT-R, Sop color word test of relatives group at the first level of schizophrenia, with significant difference in color word score and control group, all P? 0. 01, with statistical significance, the results of continuous operation test (CPT) were different from those in the control group, all of which were different from those in the control group. 0. 05, with statistical significance, the results of other MCCB were not statistically significant compared with the normal control group. There was no statistical significance. There was a significant difference between the first group of positive family history and the initial group without positive family history, HVLT-R (total score, T3), CPT-IP (total score, 2D). P鍧，
本文編號：2263649
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