精神分裂症患者脑CT与临床的10年随访研究

目的探讨精神分裂症的脑萎缩与临床表现的相关性。方法对３２例精神分裂症患者的脑ＣＴ与临床进行了１０年的随访研究，采用简明精神病评定量表、阴性症状量表、阳性症状量表、社会功能缺陷筛选量表、简易智力状态检查对其临床症状、社会功能和智能状况进行评定。结果１０年前３２例患者中有５例（１６％）脑萎缩，１０年后为１０例（３１％）脑萎缩；８例脑室大小正常，但双侧脑室不对称；１４例正常。随访时量表评定结果提示，该组患者以阴性症状为主，社会功能下降，认识功能有不同程度的损害，脑萎缩患者与非脑萎缩患者比较，差异未见显著性，但病程明显长于非脑萎缩患者。精神分裂症患者的脑萎缩与精神病家族史、亚型和各项治疗无明显关系。结论精神分裂症患者的脑结构异常与病程呈正相关。

Ten year follow up study of cerebral CT and clinical features of schizophrenics

Objective This study determined the correlation of cerebral atrophy with clinical features in schizophrenia. Methods A ten year follow up study was performed in 32 patients. The Brief Psychiatric Rating Scale, Scale for Assessment of Negative Symptoms, Scale for Assessment of Positive Symptoms, Social Disability Screening Schedule and Mini Mental State Examination were used to assess their clinical symptoms, social function and intelligence. Results 5 cases had brain atrophy 10 years ago and this number increased to 10 after 10 years. 8 of them had asymmetric but normal sized ventricles. The other 14 were normal on brain CT. Scale assessment indicated that the patients in this study were characterized with negative symptoms, lowered social function and impaired cognition, but those were not correlated with cerebral atrophy. A longer illness course was noted in patients with than without cerebral atrophy. There is no significant correlation between brain atrophy and family history, schizophrenia subtypes and the treatments they have received. Conclusion It is suggested that the change of brain structure was correlated with the illness course in schizophrenic patients.