CAJ | 학술논문

目的研究精神分裂症单发家系和高发家系患者及其亲属的认知功能,探讨遗传负荷对精神分裂症患者认知功能的影响.方法使用威斯康星卡片分类测验(WCST)、修订韦氏成人智力量表(WAIS-R)的词汇测验(VS)、多维记忆评估量表(MMAS)的数字广度、汉词广度和空间广度测验及持续注意测验(CPT)对精神分裂症单发家系患者组(21例)及其一级亲属(单发家系亲属组,55例),高发家系患者组(30例)及其一级亲属(高发家系亲属组,26例),对照家系组(14名)及其一级亲属(对照家系亲属组,29名)进行研究.结果高发家系患者组和高发家系亲属组的VS[(9.3±3.9)分vs(13.6±2.2)分和(10.7±4.0)分vs(13.9±2.3)分]和部分记忆广度成绩均明显低于对照家系组分及对照家系亲属组,其WCST卡片总数、持续错误数[(27.9±13.0)分vs(18.3±8.4)分和(26.0±16.3)分vs(18.3±8.7)分]和随机错误数及CPT视觉、听觉漏报数和反应时间均明显多于对照家系组分和对照家系亲属组分,差异有统计学意义(ANOVA,P＜0.05);单发家系患者组CPT视觉漏报[(68.7±18.4)分vs(49.0±3.4)分]和反应时间、听觉错报和漏报多于对照家系组,差异有统计学意义(ANOVA,P＜0.05),单发家系亲属组的VS低于对照家系亲属组[(12.0±3.9)分vs(13.9±2.3)分],WCST卡片总数多于对照家系亲属组,差异有统计学意义(ANOVA,P＜0.05).结论精神分裂症高发家系认知成绩最差,单发家系患者及亲属大部分认知成绩介于高发家系和对照家系之间;随着遗传负荷的增加,患者及亲属的认知缺陷更为明显,认知功能缺陷可能是精神分裂症遗传易感性的标志之一.
목적 연구정신분렬증단발가계화고발가계환자급기친속적인지공능,탐토유전부하대정신분렬증환자인지공능적영향.방법 사용위사강성잡편분류측험(WCST)、수정위씨성인지역량표(WAIS-R)적사회측험(VS)、다유기억평고량표(MMAS)적수자엄도、한사엄도화공간엄도측험급지속주의측험(CPT)대정신분렬증단발가계환자조(21례)급기일급친속(단발가계친속조,55례),고발가계환자조(30례)급기일급친속(고발가계친속조,26례),대조가계조(14명)급기일급친속(대조가계친속조,29명)진행연구.결과 고발가계환자조화고발가계친속조적VS[(9.3±3.9)분vs(13.6±2.2)분화(10.7±4.0)분vs(13.9±2.3)분]화부분기억엄도성적균명현저우대조가계조분급대조가계친속조,기WCST잡편총수、지속착오수[(27.9±13.0)분vs(18.3±8.4)분화(26.0±16.3)분vs(18.3±8.7)분]화수궤착오수급CPT시각、은각루보수화반응시간균명현다우대조가계조분화대조가계친속조분,차이유통계학의의(ANOVA,P＜0.05);단발가계환자조CPT시각루보[(68.7±18.4)분vs(49.0±3.4)분]화반응시간、은각착보화루보다우대조가계조,차이유통계학의의(ANOVA,P＜0.05),단발가계친속조적VS저우대조가계친속조[(12.0±3.9)분vs(13.9±2.3)분],WCST잡편총수다우대조가계친속조,차이유통계학의의(ANOVA,P＜0.05).결론 정신분렬증고발가계인지성적최차,단발가계환자급친속대부분인지성적개우고발가계화대조가계지간;수착유전부하적증가,환자급친속적인지결함경위명현,인지공능결함가능시정신분렬증유전역감성적표지지일.
Objective By exploring cognitive function in schizophrenic patients and their relatives from simplex families and multiplex families, to identify the affect of genetic loading on cognitive function in schizophrenia. Methods Twenty-one schizophrenic patents and their 55 first-degree nonpsychotic relatives from simplex families (one family member with schizophrenia) ,21 schizophrenic patients and their 26 firstdegree nonpsychotic relatives from multiplex families ( at least two family members with schizophrenia), 14matched controls and their 29 first-degree relatives were assessed with the Wisconsin Card Sorting Test (WCST), vocabulary subtest (VS) of Wechsler Adult Intelligence Scale-revised (WAIS-R), memory span subtests (MS) of Multiple Memory Assessment Scale (MMAS) and Continuous Perfomance Test (CPT).Results Compared with controls and their relatives, the patients and their relatives from multiplex families showed significantly worse VS score [ (9. 3 ± 3.9) vs ( 13.6 ± 2. 2 ), ( 10. 7 ± 4. 0) vs ( 13. 9 ± 2. 3 ); ANOVA,P＜0.05], more WCST total cards, perseverative errors [(27.9 ± 13.0) vs ( 18.3 ± 8.4), (26.0 ±16. 3) vs ( 18. 3 ± 8.7); ANOVA, P ＜ 0. 05 ] and random errors, more visaul and acoustic omission, longer visaul and acoustic reaction time respectively(P ＜ 0. 05 ). The patients from simplex families showed more visaul omission [ (68.7 ± 18. 4) vs(49. 0 ±3.4) ;ANOVA,P ＜0. 05] and acoustic omission, acoustic errors and longer visaul reaction time than those for controls significantly ( P ＜ 0. 05 ). The relatives from simplex families only showed worse score of VS [ ( 12. 0 ± 3.9 ) vs ( 13.9 ± 2. 3 ); ANOVA, P ＜ 0. 05 ], more total cards in WCST than those for relatives of controls (P ＜0.05). Conclusions The cognitve impairments in schizophrenic patients and their relatives aggravate as the degree of genetic loading increases. Cognitive impairments may be potential endophenotypes of familial vulnerability to schizophrenia.