论文部分内容阅读
目的 探讨精神分裂症首次发病患者治疗早期神经认知功能受损的程度和范围.方法 采用成套神经心理测验工具,包括连线测验A、颜色连线测验、《韦克斯勒记忆量表(第3版)》空间广度测验、《韦克斯勒量表(第3版)》(WAIS-Ⅲ)符号搜索和数字符号、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)、沟槽钉板测验和定步调听觉连续加法测验(PASAT)测试77例16 ~ 28岁的精神分裂症首次发病患者(病例组)和80名健康者(对照组)的学习和记忆、精细动作、信息处理速度以及执行功能,采用SPSS16.0统计软件包对所有数据进行统计学分析.结果 共有21项评价指标的效应值>0.80(P <0.001),整体受损效应值在0.47 ~3.41个标准差;病例组沟槽钉板测验完成时问[利手(84.77±31.55)s,非利手(97.95 ±42.30)s]均显著长于对照组[(59.00±7.57)s,ES =3.41,F=43.28;(66.84±10.74)s,ES =2.90,F=35.75;P均<0.001],连线测验A[(50.88 ±27.45)s]、颜色连线1完成时间[(54.59±25.62)s]和颜色连线2完成时间[(117.38±52.66)s]显著长于对照组[(27.25±8.49)s,ES=2.78,F=42.66;(29.64±9.49)s,ES =2.63,F=58.82;(66.34±15.06)s,ES =3.39,F=60.51;P<0.001],PASAT尝试数[(36.43±9.88)个]和正确数[(31.11±11.09)个]显著低于对照组[(46.85±3.42)个,ES=-3.04,F=72.52;(44.15 ±5.08)个,ES=-2.57,F=81.10;P均<0.001],WAIS-Ⅲ数字符号得分[(59.81 ±15.11)分]显著低于对照组[(91.13±10.87)分,ES=-2.88,F=179.33,P<0.001],病例组BVMT-R测试各项得分显著低于对照组(P<0.050).结论 精神分裂症首次发病患者神经认知功能全面受损.“,”Objective To compare the neurocognitive function of patients with first-episode schizophrenia and the comparison subjects,with age of 16 to 28 years.Methods Seventy-seven patients experiencing their first episode of schizophrenia illness and 80 normal controls were administered a set of neuropsychological test battery,concluding the Trail Making Test A,Color Trail Making Test,Wechsler Memory Scale-Ⅲ (WMS-Ⅲ) spatial span test,WAIS-Ⅲ symbol search and digital symbol,Hopkins Verbal Learning Test-Revised (HVLT-R),Brief Visuospatial Memory Test-Revised (BVMT-R),Paced Auditory Serial Addition Test (PASAT).Results Twenty-one of 27 tests had an effect size (ES) greater than 0.80when the 2 groups were compared.all the ES in tests were between 0.47 and 3.41.The completed time of pegboard tasks [dominant hands (84.77 ± 31.55) s and subdominant hands (97.95 ± 42.30) s] was significantly longer in patients than controls [(59.00 ±7.57) s,ES =3.41,F =43.28 ; (66.84 ± 10.74) s,ES =2.90,F =35.75 ; P < 0.001].The completed time of Trail Making Test A [(50.88 ± 27.45) s],Color Trail Making Test 1 [(54.59 ± 25.62) s] and Color Trail Making Test 2 [(117.38 ± 52.66) s] were longer in patients than the controls [(27.25 ± 8.49) s,ES =2.78,F =42.66 ; (29.64 ± 9.49) s,ES =2.63,F =58.82 ; (66.34 ± 15.06) s,ES =3.39,F =60.51 ; P < 0.001].The number of PASAT attempt (36.43 ± 9.88) and correct (31.11 ± 11.09) were significantly less in patients than the controls (46.85 ±3.42,ES=-3.04,F=72.52; 44.15 ± 5.08,ES=-2.57,F=81.10; P<0.001).The score of WAIS-Ⅲ digital symbol(59.81 ± 15.11) were significantly lower in patients than the controls (91.13 ±10.87,ES =-2.88,F =179.33,P <0.001).All the scores of the BVMT-R tests were significantly lower in patients than the controls (P < 0.050).Conclusion The patients with first-episode schizophrenia possibly have significant cognitive impairments across multiple ability domains.