CAJ | 학술논문

目的比较精神分裂症首次发病患者与健康同胞及正常对照认知功能的差异,探讨精神分裂症在认知功能领域的内表型.方法采用目前常用的范畴流畅测验(CFT)、数字符号编码测验(DSCT)、连线测验(TMT)、韦克斯勒记忆量表第3版(WMS-Ⅲ)空间广度测验(WMS-ⅢSST)、霍普金斯词汇学习测验-修订版(HVLT-R)、简易视觉空间记忆测验-修订版(BVMT-R)、定步调听觉连续加法测验(PASAT)和威斯康星卡片分类测验-64(WCST-64)对92例精神分裂症首次发病患者(患者组)、56例健康同胞(同胞组)和62名健康对照者(对照组)的认知功能进行检测.结果 (1)患者组所有神经心理测验成绩均差于对照组,差异有统计学意义(P＜0.01).(2)同胞组的CFT、DSCT、TMT、HVLT-R即刻记忆和延迟记忆、BVMT-R即刻记忆、PASAT、WCST-64持续错误数、持续反应数和完成分类数的测验成绩差于对照组,差异有统计学意义(P＜0.05).(3)患者组与同胞组的CFT、WCST-64中的持续错误数、持续反应数和完成分类数测验成绩分别为(18.40±12.12)分比( 18.86±5.19)分、(16.48±8.19)分比(14.80±5.86)分、(18.76±10.91)分比(16.86 ±7.73)分、(1.33±2.81)分比(1.63±1.36)分,2组比较差异无统计学意义(P＞0.05),其他神经心理测验成绩比较,患者组差于同胞组,差异有统计学意义(P＜0.05).结论精神分裂症首次发病患者存在处理速度、工作记忆、言语记忆、空间记忆、注意警觉和执行功能广泛性的认知功能损害,精神分裂症健康同胞存在处理速度、言语记忆、视觉记忆、注意警觉、执行功能的认知缺陷；语义流畅性功能和执行功能可能是精神分裂症的潜在内表型.
목적 비교정신분렬증수차발병환자여건강동포급정상대조인지공능적차이,탐토정신분렬증재인지공능영역적내표형.방법 채용목전상용적범주류창측험(CFT)、수자부호편마측험(DSCT)、련선측험(TMT)、위극사륵기억량표제3판(WMS-Ⅲ)공간엄도측험(WMS-ⅢSST)、곽보금사사회학습측험-수정판(HVLT-R)、간역시각공간기억측험-수정판(BVMT-R)、정보조은각련속가법측험(PASAT)화위사강성잡편분류측험-64(WCST-64)대92례정신분렬증수차발병환자(환자조)、56례건강동포(동포조)화62명건강대조자(대조조)적인지공능진행검측.결과 (1)환자조소유신경심리측험성적균차우대조조,차이유통계학의의(P＜0.01).(2)동포조적CFT、DSCT、TMT、HVLT-R즉각기억화연지기억、BVMT-R즉각기억、PASAT、WCST-64지속착오수、지속반응수화완성분류수적측험성적차우대조조,차이유통계학의의(P＜0.05).(3)환자조여동포조적CFT、WCST-64중적지속착오수、지속반응수화완성분류수측험성적분별위(18.40±12.12)분비( 18.86±5.19)분、(16.48±8.19)분비(14.80±5.86)분、(18.76±10.91)분비(16.86 ±7.73)분、(1.33±2.81)분비(1.63±1.36)분,2조비교차이무통계학의의(P＞0.05),기타신경심리측험성적비교,환자조차우동포조,차이유통계학의의(P＜0.05).결론 정신분렬증수차발병환자존재처리속도、공작기억、언어기억、공간기억、주의경각화집행공능엄범성적인지공능손해,정신분렬증건강동포존재처리속도、언어기억、시각기억、주의경각、집행공능적인지결함；어의류창성공능화집행공능가능시정신분렬증적잠재내표형.
Objective To explore difference of neuropsychological tests among first-episode schizophrenia patients,their healthy siblings and healthy controls,and to explore the possible endophenotype of schizophrenia in cognitive function.Methods In all,92 first-episode schizophrenia patients,56 their healthy siblings and 62 healthy controls were assessed with the Category Fluency Test ( CFT),Digit Symbol Coding Test ( DSCT),Trail Making Test (TMT),Wechsler Memory Scale-Ⅲ Spatial Span Test ( WMS-ⅢSST ),Hopkins Verbal Learning Test-Revised (HVLT-R),Brief Visuospatial Memory Test-Revised (BVMT-R),Paced Auditory Seria Addition Test (PASAT),Wisconsin Card Sorting Test-64 (WCST-64).Results The patients showed poorer performance on all measures of neuropsychological tests than healthy controls (P ＜0.01 ).There were significantly lower performances in siblings than controls in CFT,DSCT,TMT,HVLT-R trials 1-3,HVLT-R delay,BVMT-R trials 1-3,PASAT,and perseverative errors,perseverative responses and categories completed of WCST-64 ( P ＜ 0.05 ). There were no significance between patients and siblings in CFT and perseverative errors,perseverative responses and categories completed of WSCT-64 [ ( 18.40 ± 12.12 ) vs.( 18.86 ± 5.19 ),( 16.48 ± 8.19 ) vs.( 14.80 ± 5.86 ),( 18.76 ± 10.91 ) vs.( 16.86 ± 7.73 ),( 1.33 ± 2.81 ) vs.( 1.63 ± 1.36 ) respectively ] ( P ＞ 0.05 ),but patients performed worse than siblings in other any measures ( P ＜ 0.05 ).Conclusions It indicates that the first-episode schizophrenia patients have multiple cognitive deficits in speed of processing,working memory,verbal learning and memory,visual learning and memory,attention/vigilance,and executive function,and their healthy siblings show cognitive function deficits in speed of processing,attention/vigilance,verbal learning and memory,visual learning and memory and executive function.Semantic fluency function and executive function may be the potential endophenotype of schizophrenia.