摘要
目的 动态观察药物对局部脑血流量 (rCBF)的影响 ,探索以阴性症状为主的精神分裂症患者潜隐的局部脑功能异常。方法 对 2 1例符合Andreason阴性精神分裂症标准的患者 (以下简称患者组 )于氯氮平治疗前后进行威斯康星卡片分类测验 (WCST)和单光子发射计算机断层扫描(SPECT)检查 ,以 40名正常人为对照组 (其中 2 8名为WCST对照组 ,12名为SPECT对照组 )。结果 患者组氯氮平治疗前后WCST的总测验次数、持续错误数和非持续错误数均高于对照组 (P <0 .0 5 )。阴性症状评定量表总分与持续错误数 (r=0 .45 ,P <0 .0 1)及总测验次数 (r=0 .45 ,P <0 .0 1)存在显著性正相关。氯氮平治疗使患者组的总测验次数、持续错误数和非持续错误数减少 (P <0 .0 5或 0 .0 1)。患者组氯氮平治疗前后双侧额叶和双侧颞叶的放射性相对定量值及双侧额叶的局部脑区血流变化率均低于对照组 (P <0 .0 5 )。结论 以阴性症状为主的精神分裂症患者存在认知功能缺陷和额叶及颞叶的rCBF灌注降低 ,有前额叶功能减退。氯氮平能改善阴性症状和认知缺陷 。
Objective The cognitive function and the regional cerebral blood flow at rest and during frontal activation task with WCST of baseline and post treatment of clozapine were longitudinally studied in negative schizophrenic patients. Methods 21 patients matching Andreason′s negative schizophrenia criteria received SPECT and WCST, and were treated with clozapine for eight weeks. There were 28 and 12 normal subjects as WCST and SPECT control group respectively.Results Compared with controls,poor performances on the WCST of total trials of category(TT), perseverative errors (PE) and nonperseverative errors (NPE) were found in negative schizophrenia ( P <0.05). SANS score was significantly related with poor TT( r =0.45, P <0.01) and PE performance ( r =0.45, P <0.01). The poor TT, PE and NPE tasks of WCST in negative schizophrenia were significantly improved through clozapine treatment ( P <0.05). The negative schizophrenia group had a significantly lower rCBF perfusion in the frontal and temporal lobes bilaterally at resting state, and lower rCBF change rate in bilateral frontal lobe during stimulant WCST than that in normal controls ( P <0.05). Conclusions Negative schizophrenia has cognitive deficits and lower rCBF perfusion in both frontal and temporal lobes, which suggest that negative schizophrenia has hypofrontality. Clozapine can improve negative symptoms and cognitive disturbance but without improving lower rCBF perfusion of frontal lobe.
出处
《中华精神科杂志》
CSCD
2000年第3期134-137,共4页
Chinese Journal of Psychiatry
基金
卫生部基金部分资金资助项目! (96 1 132 )
