双相障碍患者不同临床分期认知功能特点比较

目的:探讨双相障碍患者不同临床分期阶段认知功能损害的差异性。方法:选取患者190例,根据Berk等描述的分期模型为依据进行分期分成A组(首次情感发作)、B组(复发后完全缓解)、C组(难治性病程),与60例正常对照组进行比较。通过采用连线测验、迷宫、数字广度测验、威斯康星卡片分类4个神经心理测验(共11项)对入组患者与正常对照组进行认知功能的评定。结果:使用方差分析比较A组、B组、C组和对照组在连线测验、迷宫、数字广度(倒背)及威斯康星卡片分类测验(总应答数、完成分类数、持续性应答数、持续性错误数)差异均有统计学意义(F=2.93~15.08,P0.05)。进一步进行LSD检验,在注意力和处理速度上,C组花费时间高于A组(F=4.29,P0.05);在记忆力上,A组得分大于B组大于C组(F=12.48,P0.05);在执行功能上,C组应答数高于B组高于A组(总应答数F=15.08,P0.05;持续性应答数F=13.79,P0.05)。结论:双相障碍患者存在认知功能的损害,随着临床分期阶段进展,患者的认知功能损害逐渐加重尤其在记忆力、执行能力方面,临床分期有利于对双相障碍的病情评估。

Cognitive Function of Different Clinical Stagings in Patients with Bipolar Disorder

Objective:To explore thedifterenccs of cognitive impairrment in patients with bipolar disorder at diverse clinical stagings.Methods:According to the clinical staging model by Berk et al,a total of 190 patients with bipolar disorder were selected and divided into group A(first episode).group B(first relapse or full remission and recurrence),group C(refractory to treatment),compared with 60 cases of normal control group.The cognitive function were assessed with 4 neuropsychological tests(11 items)such as trail marking test(TMT),maze,digital span,Wisconsin Card Sorting Test(WCST).Results:Variance compared with A group,B group,C group and control group in trail marking test.maze,digit span(backward)and Wisconsin Card Sorting Test(total cards,categories,persistent responses,persistent errors) the differences were statistically significant(F =2.93 ～ 15.08,P ＜0.05).LSD test indicated that in attention and processing speed,the C group was longer than A group (F =4.29,P ＜ 0.05);in memory,A group scored more points than B group and C group(F =12.18,P＜0.05);In executive function,the number of responses C group were higher than B group and A group(total number of responses(F=15.08,P＜0.05);Number of persistent responses(F =13.79.P ＜ 0.05).Conclusion:The pat tents with bipolar disorder have cognitive impairment,with the development of clinical stage,the cognitive function impairment of patients is gradually increasing,especially in memory and executive functions,and clinical staging is beneficial to the assessment of the condition of bipolar disorder.