摘要
目的研究首发精神分裂症患者的认知功能及其与血清同型半胱氨酸(Hcy)水平的关系。方法采用词汇流畅测验、视觉再生测验、联想学习测验、数字广度测验、相似性测验、领悟测验、木块图测验、威斯康星卡片分类测验(WCST)8项神经心理测试工具,对57例首发精神分裂症患者于治疗前和非典型抗精神病药治疗8周后各评定认知功能1次,同时采用酶免疫法测定其血清Hcy水平,阳性与阴性症状量表(PANSS)评定临床症状。结果①治疗前,除WCST的随机错误数外,患者组各项认知功能指标均显著差于正常对照(P<0.01);血清Hcy水平明显高于正常对照(P<0.01);患者组中WCST的正确数、完成分类数与血清Hcy水平呈负相关(r=-0.376,P<0.01;r=-0.397,P<0.01),WCST的错误总数、持续错误数与血清Hcy水平呈正相关(r=0.376,P<0.01;r=0.298,P<0.05)。②治疗后,患者组PANSS总分显著下降(P<0.01);认知功能除WCST的随机错误数外较治疗前有所改善(P<0.05),但总体仍显著差于正常对照(P<0.01);血清Hcy水平无显著变化;患者组中WCST的正确数、完成分类数仍与血清Hcy水平呈负相关(r=-0.388,P<0.01;r=-0.383,P<0.01),WCST的错误总数、持续错误数仍与血清Hcy水平呈正相关(r=0.388,P<0.01;r=0.315,P<0.02)。结论精神分裂症患者存在认知损害,其执行功能损害可能与Hcy的代谢失衡有关。
Objective To study the cognitive function in the first-episode schizophrenics and its association with serum level of homocysteine. Methods Fifty-seven first-episode schizophrenic patients were collected. Cognitive functions of all patients were evaluated with 8 neuropsychological tests which included in semantic fluency, visual reproduction, asso- ciation learning, digit span , similarity, comprehension , block design , Wisconsin card sorting test （WCST） before and after 8-week atypical antipsychotics treatment. Their serum level of homocysteine was measured by enzyme immunoassays at the same time. Clinical symptoms were assessed with Positive and Negative Syndrome Scale （PANSS）. Results ①Before treatment, the performance of cognitive tests in schizophrenic group was significantly poorer than that in normal group except for random errors of WCST（ P 〈 0. 01 ） ;the serum level of homocysteine in schizophrenic group was significantly higher than that in normal group（ P 〈 0. 01 ） ;the correct and the categories achievement of WCST in schizophrenic group were negatively correlated with the serum level of homocysteine（r = -0. 376, P 〈0.01 ; r = -0. 397 ,P 〈0. 01 ） ,and the total errors and the perseverative errors of WCST in schizophrenic group were positively correlated with the serum level of homocysteine（ r = 0. 376,P 〈0. 01 ; r = 0. 298,P 〈0. 05）. ②After treatment,total scores of PANSS decreased significantly （P 〈0.01 ） ;the performance of cognitive tests in schizophrenic group was improved except for random errors of WCST（ P 〈 0.05 ）, but still significantly poorer than that in normal group in general（ P 〈 0. 01 ） ;the serum level of homocysteine in schizophrenic group was unchanged; the correct and the categories achievement of WCST in schizophrenic group remained negatively correlatedwith the serum level of homocysteine（ r = -0. 388,P 〈 0. 01 ; r = -0. 383, P 〈 0. 01 ）, and the total errors and the persev- erative errors of WCST in schizophrenic
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2007年第11期652-656,共5页
Chinese Journal of Nervous and Mental Diseases
基金
苏州市科技计划项目(编号:SZD0639)
太仓市科技发展计划项目(编号:TS0604)
