精神分裂症首发患者的非匹配负波及P300随访研究

目的了解精神分裂症首发患者非匹配负波（MMN）和P300的特征以及治疗缓解后脑电波的变化。方法应用美国Bravo脑电生理仪,比较58例首发分裂症患者和54名健康人的MMN和P300电位,并用阳性和阴性症状量表（PANSS）评定患者精神症状。患者组于治疗5周和14周时随访MMN和P300。结果①精神分裂症首发患者组的MMN潜伏期[（222.4±33.0）ms]比正常对照组[（200.5±30.1）ms]延迟（t=3.66,P〈0.01）,波幅[（4.6±3.3）μV]比对照组[（7.9±3.9）μV]低（t=4.85,P〈0.01）。患者组P300中靶潜伏期P3同时延迟;②MMN潜伏期延长和波幅低,与PANSS阳性症状和思维障碍分呈负相关（r=-0.381,P〈0.05,r=-0.459,P〈0.01）;患者组经治疗14周后,MMN波幅呈增大改变和潜伏期缩短。结论MMN和P300联合应用可能作为精神分裂症首发患者临床检测指标。

Follow-up study of mismatch negativity and P_(300) in first-episode schizophrenia

Objective： To investigate the characteristics of mismatch negativity （MMN） and P300 in first- episode schizophrenia and its variation after treatment. Methods： MMN and P300 were recorded in 58 schizophrenics and 54 normal controls （NC） with American Brova instrument, and their psychotic symptoms were assessed with PANSS. Results ： Compared with NC , there were delayed MMN latency [ NC ： （ 200.5 ± 30.1 ） ms, schizophrenia ： （222.4 ± 33.0 ） ms, P 〈 0.01 ] , decreased MMN amplitude [ NC ： （7.9 ± 3.9 ） μV, schizophrenia： （ 4.6 ± 3.3 ） μV, P 〈 0.01 ] , and delayed P3 latency of P300 （ P 〈 0.01 ） in schizophrenia group than that in the control group. The delayed MMN latency and decreased MMN amplitude were negatively correlated with positive symptoms and thought disorder in schizophrenia（ r = -0.381 ,P 〈 0.05, r = -0. 459, P 〈0.01 ）. After 14 weeks treatment, MMN amplitude invreased and MMN latency decreased. Conclusion： MMN and P300 may be a biological marker in detecting first - episode schizophrenics.