【摘要】 目的探讨首发未用药精神分裂症患者伴胰岛素抵抗对认知功能的影响。方法选取2017年9月至2019年6月在郑州大学第一附属医院精神科就诊的首发未用药精神分裂症患者131例作为观察组,同时纳入郑州大学第一附属医院医护人员及来体检的健康志愿者90例作为对照组,根据胰岛素抵抗指数(HOMA-IR)将观察组分为IR组和no-IR组。采用稳态模式评估法(HOMA)评价受试者胰岛素抵抗情况,阳性和阴性症状量表(PANSS)评定患者精神症状,认知功能成套测验(MCCB)评估患者认知功能。结果 (1)观察组空腹血清胰岛素水平,HOMA-IR值高于对照组(均P<0.001);观察组认知功能七大领域得分差于对照组(均P<0.001)。(2)IR组和no-IR组PANSS评分差异无统计学意义(均P>0.05);IR组MCCB中的信息处理速度,注意及警觉性,工作记忆,视觉学习差于no-IR组(均P<0.05)。结论首发未用药精神分裂症患者存在空腹血清胰岛素水平升高,伴胰岛素抵抗的患者对比无胰岛素抵抗的患者认知功能损害更为严重。更多还原

【Abstract】 Objective To investigate the effect of insulin resistance on cognitive function in drug naive first episode schizophrenia patients.Methods A total of 131 drug naive first episode schizophrenia patients from the First Affiliated Hospital of Zhengzhou University were selected as the observation group, 90 healthy volunteers including the medical staff and people for physical examination were included as the control group. According to HOMA-IR, observation group were divided into the IR group and the no-IR group. Insulin resistance index was calculated in the form of HOMA. Positive and negative syndrome scale(PANSS) was used to evaluate the mental symptoms, matrics consensus cognitive battery(MCCB) was used to evaluate the cognitive function.Results(1) The serum fasting insulin level and HOMA-IR value of the observation group were higher than the control group(all P<0.001). The scores of the seven areas of cognitive function in the observation group were worse than the control group(all P<0.001).(2)There were no significant difference in PANSS scores between IR group and no-IR group(all P>0.05). Speed of processing, attention/vigilance, working memory and visual learning in the IR group were worse than the no-IR group(all P<0.05).Conclusion The drug naive first episode schizophrenia patients have elevated serum fasting insulin levels, patients with insulin resistance have severer cognitive impairment than patients without insulin resistance.更多还原