阴、阳性症状为主的精神分裂症患者神经认知功能的比较研究

目的：探讨阳性症状为主型（阳性型）及阴性症状为主型（阴性型）精神分裂症患者的神经认知功能状况。方法：采用木块图、线方向判断、视觉再生、理解记忆、连线及威斯康星卡片分类（WCST）测验，对25例阴性型精神分裂症患者和20例阳性型精神分裂症患者进行评定。结果：阴性组患者的视觉再生、理解记忆、木块图，连线B时间、思维灵活性以及WCST持续性错误百分数、完成分类数等成绩显著低于阳性组；其中木块图、连线B时间、思维灵活性以及WCST持续性错误百分数指标与SANS总分均有显著相关；视觉再生、理解记忆测验得分及WCST完成分类数与SANS及SAPS总分均有显著相关。结论：不同亚型精神分裂症患者神经认知功能损害的特点不同。顶叶及额叶功能下降与阴性症状关系密切；而颞叶功能下降与阴性、阳性症状均密切相关。

A Comparative Study of Neurocognitive Fumction in Schizophrenics with Positive and Negative Symptorms

Objective: To compare the differences between the schizophrenics with positive and negative symptoms in neurocognitive functions.Methods: A neuropsychological test battery for memory,visuospatial,executive function were used to assess 25 negative subtype and 20 positive subtype schizophrenics.Results: Negative subtype schizophrenia performed more poorly than positive subtype schizophrenia in the Block Design test,the Trial Making B time,the flexibility index and the Rpe%,and Cc of WCST.The Block Design score,Trial Making B time,the flexibility index and the Rpe% index of WCST were significantly correlated with the total score of SANS,and correlated with none of the total score of BPRS and SAPS.The Visual Reproduction score,Logical Memory score and the Cc index of WCST were significantly correlated with the total score of BPRS and SAPS.Conclusion: Negative subtype schizophrenics may have greater impairments on neurocognitive function associated with frontal and parietal lobe dysfunction than positive subtype schizophrenics.Furthermore,impairment of both subtypes were closely related to temporal lobe dysfunction,whereas negative subtype showed more serious impairment.