精神分裂症患者感觉门控P50电位研究的系统评价

目的 评价中国人群精神分裂症患者感觉门控P50电位的特点及治疗前后变化.方法 检索PubMed、EMBase、Web of Knowledge、中国期刊网、万方、维普及中国生物医学文献等数据库,检索时间为1982年1月1日至2010年1月8日.应用加强观察性流行病学研究报告的质量(STROBE)为参照标准评价文献质量,采用RevMan软件进行荟萃分析.结果 共检索到71篇文献,7项研究符合纳入标准.随机效应进行荟萃分析,结果显示精神分裂症组S1波幅低于正常对照组(P=0.02),S2波幅高于正常对照组(P=0.001),差异有统计学意义.精神分裂症组S1潜伏期(P=0.34)和S2潜伏期(P=0.19)与正常对照组比较,差异均无统计学意义.精神分裂症组的P50比值明显高于正常对照组,差异有统计学意义[P＜0.00001,合并SMD=44.18,95%CI(36.62,51.74)],两组P50差值的差异无统计学意义(P=0.14).固定效应计算结果,精神分裂症患者治疗前后P50比值的差异无统计学意义(P=0.19).结论 P50比值是反映感觉门控的稳定可靠指标,精神分裂症患者存在感觉门控异常.抗精神病药物可部分改善其感觉门控异常,但不能完全逆转P50抑制缺损.

P50 sensory gating studies in schizophrenics: a systematic review

Objective To conduct a systematic review of P50 sensory gating studies in schizophrenics and the change between before and after treatment. Methods Standard search strategy for the Cochrane Review Group was performed by two review authors. Searches were made in PubMed,EMBase, Web of knowledge, PsycINFO, Cochrane Library, CNKI, Wanfang, VIP and CBMDisc databases.STROBE (strengthening the reporting of observational studies in epidemiology) was used to assess the methodological quality of the studies. RevMan 5. 0. 23 software was employed to conduct a Meta analysis.Results Seventy-one literatures were reviewed and 7 studies met the inclusion criteria for a Meta analysis.The meta-analysis of random effects showed that S1 amplitude was lower in the schizophrenia group than in the normal control group (P=0. 02). And S2 amplitude was significant higher in schizophrenia group than the normal control group ( P = 0. 001 ). There were no statistical significance in S1 and S2 latency between two groups (P = 0. 34 and P = 0. 19 respectively). P50 Ratio in schizophrenia group was significantly higher than the normal control group. And the difference was statistically significant [Z = 11.46, P ＜0. 00001,combined SMD =44. 18, 95% CI (36. 62, 51.74)]. However the P50 difference showed no significant difference (P = 0. 14). An analysis of fixed effects showed that the P50 Ratio difference was not statistically significant in schizophrenics between before and after treatment (P = 0. 19 ) . Conclusion The schizophrenics have a sensory gating dysfunction. P50 Ratio is a stable and reliable indicator of sensory gating function. Antipsychotics may partly enhance P50 sensory gating in schizophrenics, but can not completely reverse the defect of P50 suppression.