CAJ | 학술논문

目的探讨首发男性精神分裂症患者认知功能的损害特点,以及认知功能损害与精神症状的关联性.方法对43例符合精神分裂症诊断标准首次发作男性患者,在其精神症状好转前后,即治疗前与治疗8周后分别用华文认知能力测验(CCAS)和阳性及阴性症状量表(PANSS)评定,同时对患者的临床特征进行研究.结果首发男性精神分裂症患者治疗前后认知功能与精神症状评分差异有统计学意义(P＜0.01).精神症状治疗前患者认知能力总分[(85.7 ±11.5)分]以及各认知功能因子学习能力[(17.9±2.3)分]、推理能力[(16.1±3.4)分]、加工速度[(16.9±2.1)分]、工作记忆[(13.8±2.6)分]、空间/计算[(17.5±2.9)分]、言语智商[(86.8±11.7)分]、操作智商[(83.9±12.4)分]；精神症状治疗后患者认知能力总分[(97.6±14.3)分]以及各认知功能因子[学习能力(20.1±2.9)分、推理能力(18.9±3.1)分、加工速度(19.7±1.8)分、工作记忆(15.7±2.5)分、空间/计算(20.8±2.5)分、言语智商(98.3±13.7)分、操作智商(95.8±14.6)分,P＜0.01].治疗前后IQ的差值与PANSS总分差值及阳性总分差值具有正相关性(r值分别为0.596及0.783).结论 (1)首发男性精神分裂症患者在发病初期就存在认知功能损害；(2)非典型抗精神病药改善精神分裂症临床症状的同时对改善患者认知功能损害具有一定作用；(3)精神分裂症患者认知功能的改善与患者阳性症状的好转具有一定的正相关,而与阴性症状改善相关无统计学意义.
목적 탐토수발남성정신분렬증환자인지공능적손해특점,이급인지공능손해여정신증상적관련성.방법 대43례부합정신분렬증진단표준수차발작남성환자,재기정신증상호전전후,즉치료전여치료8주후분별용화문인지능력측험(CCAS)화양성급음성증상량표(PANSS)평정,동시대환자적림상특정진행연구.결과 수발남성정신분렬증환자치료전후인지공능여정신증상평분차이유통계학의의(P＜0.01).정신증상치료전환자인지능력총분[(85.7 ±11.5)분]이급각인지공능인자학습능력[(17.9±2.3)분]、추리능력[(16.1±3.4)분]、가공속도[(16.9±2.1)분]、공작기억[(13.8±2.6)분]、공간/계산[(17.5±2.9)분]、언어지상[(86.8±11.7)분]、조작지상[(83.9±12.4)분]；정신증상치료후환자인지능력총분[(97.6±14.3)분]이급각인지공능인자[학습능력(20.1±2.9)분、추리능력(18.9±3.1)분、가공속도(19.7±1.8)분、공작기억(15.7±2.5)분、공간/계산(20.8±2.5)분、언어지상(98.3±13.7)분、조작지상(95.8±14.6)분,P＜0.01].치료전후IQ적차치여PANSS총분차치급양성총분차치구유정상관성(r치분별위0.596급0.783).결론 (1)수발남성정신분렬증환자재발병초기취존재인지공능손해；(2)비전형항정신병약개선정신분렬증림상증상적동시대개선환자인지공능손해구유일정작용；(3)정신분렬증환자인지공능적개선여환자양성증상적호전구유일정적정상관,이여음성증상개선상관무통계학의의.
Objective To study the characteristic of cognitive function impaired and its relationship with the psychiatric symptoms in patients with first-episode schizophrenia.Methods 43 first-episode male schizophrenia patients diagnosed with DSM-Ⅳ were recruited in the study and received the atypical antipsychotics treatment 8weeks.The total score and sub-scores of Chinese Cognitive Ability Scale (CCAS)were obtained for all the patients pre-and post-treatments,and the patients were also assessed by the Positive and Negative Syndrome Scale (PANSS).Results The differences of the intelligence quotient(IQ) and its cognitive function factors between pre-and post-treatment of the patients were significant(P＜ 0.01).The total IQ score (85.7 ± 11.5),learning ability (17.9± 2.3),reasoning ability (16.1 ± 3.4),processing speed (16.9 ± 2.1),working memory (13.8 ± 2.6),space/calculate (17.5 ± 2.9),verbal IQ (86.8 ± 11.7),performance IQ (83.9 ± 12.4) before treatment and cognitive score (97.6 ± 14.3) as well as cognitive function factor (learning ability (20.1 ± 2.9),reasoning ability (18.9± 3.1),processing speed (19.7 ± 1.8),working memory (15.7 ± 2.5),space/calculate (20.8 ± 2.5),verbal IQ (98.3 ± 13.7),performance IQ (95.8 ± 14.6) after treatment,there were significant differences pre-and posttreatment (P ＜ 0.01).The difference of IQ pre-and post-treatment was significantly correlated with that of total score and positive score of PANSS(r =0.596 or 0.783).Conclusions (1) This finding supports that the cognitive function impairment exists in the early stage of schizophrenia.(2)The typical antipsychotic drugs can improve the cognitive function impairment and psychiatric symptoms of schizophrenia.(3) The cognitive function impairment of schizophrenia has significant relation to the positive symptoms,but no relation to the negative symptoms.