上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

首发精神分裂症、超高危及高危人群的神经认知功能对照研究

王文政1， 石莹莹2*， 于欣3， 蒲城城3   

  1. 1.上海交通大学附属精神卫生中心， 上海 200030； 2.北京大学国际医院， 北京 102206； 3.北京大学精神卫生研究所， 北京大学第六医院， 卫生部精神卫生学重点实验室（北京大学）， 北京 100191
  • 出版日期:2016-10-28 发布日期:2016-11-29
  • 通讯作者: 蒲城城， 电子信箱： pciami@163.com。
  • 作者简介:王文政（1983—）, 女， 住院医师, 博士； 电子信箱： fffty@163.com。 石莹莹（1988—）， 女, 住院医师, 硕士； colette_xy@163.com。*为共同第一作者。
  • 基金资助:

    北京市科学技术委员会重点项目(D121100005012004)

A control study on neurocognitive function in first episode schizophrenia, ultra-high-risk, and high-risk populations

WANG Wen-zheng1， SHI Ying-ying2*， YU Xin3， PU Cheng-cheng3   

  1. 1.Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China； 2.Peking University International Hospital, Beijing 102206, China； 3.Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health, Beijing 100191, China
  • Online:2016-10-28 Published:2016-11-29
  • Supported by:

    Key Project of Beijing Municipal Science and Technology Commission, D121100005012004

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摘要：

目的·比较首发精神分裂症、超高危及高危人群的神经认知功能特点。方法·选取符合精神病风险综合征诊断标准的22例超高危患者（超高危组）、符合《美国精神障碍诊断和统计手册》（第4版）诊断标准的57例精神分裂症首次发病的急性期患者（急性期组）和34例精神分裂症患者一级亲属（高危组）。采用霍普金斯词语学习测验(修订版)、简易视觉空间记忆测验(修订版)、沟槽钉板测验、连线测验A、颜色连线测验Ⅱ、威斯康星卡片分类测验、范畴流利测验、斯特鲁色词测验、符号编码测验、定步调听觉连续加法测验评价3组人群的神经认知功能。结果·在所有神经认知测验中，高危组沟槽钉板测验非利手精细动作（39.47±12.30）受损最为明显，超高危组简易视觉空间记忆测验图形记忆（38.75±8.21）和沟槽钉板测验利手精细动作（36.45±8.52）受损更为明显，急性期组沟槽钉板测验利手精细动作（32.04±10.55）、沟槽钉板测验非利手精细动作（28.82±10.78）、颜色连线测验Ⅱ（32.06±14.99）受损更为明显。3组间比较，除了范畴流利测验、斯特鲁单词和威斯康星卡片分类测验，超高危组在所有认知变量中的得分都是介于高危组和急性期组之间的。结论·首发精神分裂症、超高危及高危人群的神经认知功能损害各有特点，不同神经认知功能领域可能在精神分裂症疾病发展过程中有着不同的发展轨迹。超高危患者在神经认知领域存在广泛和显著的损害，其程度介于未患病的一级亲属和首发精神分裂症患者之间。

关键词: 神经认知功能, 精神分裂症, 超高危

Abstract:

Objective·To compare the neurocognitive function between first episode schizophrenia, ultra-high-risk population, and high-risk population. Methods·Twenty-two ultra-high-risk patients met the Criteria of Psychosis-risk Syndromes (ultra-high-risk group), 57 first episode schizophrenia patients who were at acute phase and met  “Diagnostic and Statistical Manual of Mental Disorders” (4th edition)(first episode group), and 34 first-degree relatives of patients with schizophrenia (high-risk group) were selected. Hopkins Verbal Learning Test-Revised, Brief Visuospatial Memory Test-Revised, Groove Pegboard Test, Trail Making Test A, Color Trail Making Test Ⅱ, Wisconsin Card Sorting Test, Category Fluency Test, Stroop Color Word Test, Symbol Coding Test, Paced Auditory Seria Addition Test were used to evaluate the neurocognitive function in three groups. Results·In all neurocognitive tests, the damage of subdominant hands in fine motor of Groove Pegboard Test (39.47±12.30) in the high-risk group was the most obvious. The damage of Brief Visuospatial Memory Test-Revised (38.75±8.21) and dominant hands in fine motor of Groove Pegboard Test (36.45±8.52) in the ultra-high-risk group was the most significant, while the damage of dominant hands (32.04±10.55) and subdominant hands (28.82±10.78) in fine motor of Groove Pegboard Test, and Color Trail Making Test Ⅱ (32.06±14.99) in the first episode group was the most obvious. In three groups, scores of all cognitive tests in the ultra-high-risk group were between those in the high-risk group and the first episode group except the Category Fluency Test, Stroop Color Word Test, and Wisconsin Card Sorting Test. Conclusion·First episode schizophrenia, high-risk, and ultra-high-risk populations have different neurocognitive impairments. Different areas of nerve cognitive function may develop differently in the process of schizophrenia development. Ultra-high-risk patients have extensive and significant impairments in nerve cognitive area with the degree between unaffected first-degree relatives and first-episode schizophrenia.

Key words: neurocognitive, schizophrenia, ultra-high-risk