【摘要】 目的:观察强迫症患者感觉-运动整合功能最敏感的指标探究性眼球运动与其临床变量的关系。方法:选择2002-01/2004-01在北京大学精神卫生研究所门诊首次就诊的强迫症患者58例作为病例组,按用药情况分为2组,用药组30例,未用药组28例。北京大学精神卫生研究所职工和实习生为对照组,共30例。分别对各组进行探究性眼球运动检查并进行评分,评定指标包括眼球注视点数、眼球注视总长度、眼球注视平均长度、认知性探究分、反应性探究分及判别分析值(正分为异常,负分为正常)。并分析探究性眼球运动指标与临床指标的关系。结果:未用药组有1例因头围过大,无法使用眼球运动仪而退出,用药组、未用药组及对照组分别有30,27及30例进入结果分析。①病例组患者探究性眼球运动指标反应性探究分、眼球注视点数、认知性探究分以及眼球注视总长度均低于正常对照组(t=2.02～3.90,P<0.05或<0.01),判别分高于对照组(t=-4.37,P<0.01)。②病例组判别分的异常率显著高于对照组犤37%,8%,(χ2=0.56,P<0.01)犦。与判别分正常的强迫症患者相比,判别分异常的强迫症患者自知力较差(t=2.52,P<0.05)。③用药组、未用药组及对照组的判别分、反应性探究分、认知性探究分、眼球注视点数及眼球注视总长度之间差异均存在显著性意义(F=5.19～10.49,P<0.05或<0.01)。④多元逐步回归分析结果显示,反应性探究分仅与思维形式障碍有关;认知性探究分与强迫症状诱发因素、病程、精神运动迟缓分、Mausley强迫症状总分有关;眼球注视点数与强迫症状诱发因素、用药和抑郁有关;眼球注视总长度与强迫症状诱发因素及用药有关。结论:强迫症患者探究性眼球运动指标存在异常,而且与强迫症状、诱发因素、病程及精神运动迟缓分等临床指标相关。更多还原

【Abstract】 AIM: To observe the correlation between exploratory eye movement, which was the most sensative index of the sensory-movement integration in patients with obsessive-compulsive disorders, and the clinical variances.METHODS: Fifty-eight patients with obsessive-compulsive disorders (patient group), who were firstly treated in the Mental Health Institute of Peking University between January 2002 and January 2004, were divided into medication group (n=30) and non-medication group (n=28) according to their condition of medication; The employees and training students in the Mental Health Institute of Peking University were taken as controls (control group, n=30). All the subjects in each group received the examination of exploratory eye movement and scorign; The evaluation indexes included number of eye fixation, total eye scanning length, mean eye scanning length, cognitive search score, responsive search score and the discriminant score (positive score as abnormal and negative score as normal). The association between the indexes of exploratory eye movement and the clincial indexes was analyzed. RESULTS: One case quitted in the non-medication group because that his head circumference was too big to use the ocular movement apparatus. There were 30, 27 and 30 cases in the medication group, non-medication group and control group respectively were involved in the analysis of results. ① The cases in the patient group had lower exploratory eye movement indexes of responsive search score, number of eye fixation, cognitive search score and total eye scanning length (t=2.02 to 3.90, P < 0.05 or < 0.01), but higher discriminant score than those in the normal control group, and the was higher (t =4.37, P < 0.01). ② The abnormal rate of discriminant score was significantly higher in the patient group than in the cotnrol group (37%, 8%, χ2=0.56, P < 0.01). Compared with the patients with obsessive-compulsive disorders had normal discriminant score, those with abnormal discriminant score had worse insight (t=2.52, P < 0.05). ③ There were significant differences in the discriminant score, responsive search score, cognitive search score, number of eye fixation and total eye scanning length among the medication group, non-medication group and control group (F=5.19 to 10.49, P < 0.05 or < 0.01). ④ The results of multivariate stepwise regression analysis showed that responsive search score was only correlated with disorder of thought pattern; Cognitive search score was correlated with the inducement and course of obsessive-compulsive symptoms, slowness or retardation and the total score of Mausley obsessive-compulsive symptom; Number of eye fixation was associated with the inducement of obsessive-compulsive symptoms, medication and depression; Total eye scanning length had correlations with the inducement of obsessive-compulsive symptoms and medication. CONCLUSION: There are abnormalites of the indexes of exploratory eye movement in patients with obsessive-compulsive disorders, and they are correlated with some clincal indexes of the symptoms, inducement and course of obsessive-compulsive disorder, and the scores of slowness or retardation.更多还原