慢性老年精神分裂症患者与Alzheimer病的认知功能及脑CT比较

目的分析正常老年人（ＮＣ）与认知功能相对保存的慢性老年精神分裂症（Ｓ１）、认知功能缺损的慢性老年精神分裂症（Ｓ２）及Ａｌｚｈｅｉｍｅｒ病（ＡＤ）、Ｓ１与Ｓ２之间认知和脑萎缩情况的异同，探索慢性分裂症认知功能减退的本质及器质性基础。方法应用一组神经心理测验与头颅ＣＴ扫描检测４１例ＮＣ、１９例Ｓ１、１９例Ｓ２及３８例ＡＤ患者。结果４组样本以认知功能评定成绩好坏依次排序：ＮＣ为最好；其次为Ｓ１，Ｓ２和ＡＤ最差。Ｓ２的认知损害模式与ＡＤ有所不同。脑ＣＴ测量显示的脑萎缩程度：ＡＤ最重，其后的是顺序为Ｓ２，Ｓ１，ＮＣ。Ｓ１与ＮＣ相比，存在以颞叶萎缩为主的局灶性损害，Ｓ２组脑萎缩较Ｓ１组弥漫且严重，但较ＡＤ轻。结论提示Ｓ２组认知功能损害是精神分裂症的自然结果，而不是因为合并了ＡＤ；精神分裂症有可能是一种异质性疾病。

Comparisons of cognitive functions and brain CT scanning between chronic elderly schizophrenia and patients with Alzheimer disease

Objective This study examined the differences of cognitive impairment and brain structure changes between normal controls (NC) and chronic schizophrenia with relative hold of cognitive functions (S1), chronic schizophrenia with severe cognitive deficits (S2) and patients with Alzheimer disease (AD). Methods 5 neuropsychological tests and cranial computed tomography scanning were performed in 41 NC, 19 S1, 19 S2 and 38 AD. Results 1. cognitive functions assessed by neuropsychological tests were NC>S1>S2=AD; 2. brain atrophy measured on CT were AD> S2> S1>NC; 3. S1 had local brain lesion showing temporal atrophy briefly compared with NC, but lesser than S2; 4. there were significant differences in cognitive deficits pattern and degree of brain atrophy between S2 and AD. Conclusion The results suggest that schizophrenia is likely to be a heterogeneous disease and cognitive impairment of S2 patients is the result of the development of schizophrenia, not the result combined with of AD.