【摘要】 目的　探讨晚发精神分裂症患者局部脑血流 (rCBF)及认知功能损害的特点。方法　对2 1例首次发病年龄≥ 5 0岁的精神分裂症患者进行脑单光子发射计算机体层摄影术 (SPECT)检查 ,并采用阳性和阴性症状量表 (PANSS)、简易精神状态量表 (MMSE)、中国修订韦克斯勒成人智力量表、韦克斯勒记忆量表 (WMS)及威斯康星卡片分类测验等进行评定 ,经利培酮 [(2 7± 0 8)mg/d ,2次 /d]治疗 8周后 ,其中 11例患者 (PANSS减分率大于 2 5 % )再次完成上述测定。 2 0名正常人完成SPECT、MMSE及WMS测定。结果　 (1)治疗前患者组左额叶、左顶叶、双侧颞下、双侧基底节及右丘脑 (P <0 0 1)的放射性计数比值 (RAR)低于对照组 (P <0 0 5 ) ,且左额叶RAR (0 85± 0 11)低于右额叶(0 86± 0 10 ;P =0 0 13) ;其MMSE评分 (2 3 33± 4 10 )低于对照组 [(2 8 35± 1 6 3)分 ,P <0 0 1];WMS总分及其大部分测验项目分亦均低于对照组 (P <0 0 1或 0 0 5 )。 (2 )治疗后患者组仅MMSE分[(2 4 73± 4 4 5 )分 ]、WMS的定向因子分 [(3 82± 1 0 8)分 ]和背数因子分 [(5 0 0± 3 4 9)分 ]高于治疗前[分别为 (2 2 4 5± 3 98)分、(3 18± 1 0 8)分和 (2 6 4± 3 88)分 ;P <0 0 5 ],而各脑区rCBF及其余认知功能的变化均无显更多还原

【Abstract】 Objectives To figure out the characteristics of the regional cerebral blood flow (rCBF) and cognitive impairments and the relationships between symptoms and rCBF in late onset schizophrenic patients Methods Twenty one late onset schizophrenic patients diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised and 20 normal controls were enrolled in the study rCBF was assayed with the 99m Tc ECD single photon emission computed tomography Cognitive function was measured with the Wechsler Memory Scale (WMS), Mini Mental State Examination (MMSE), Wechsler Adult Intelligence Scale, and Wisconsin Card Sorting Test The patients were assessed with the Positive and Negative Syndrome Scale as well After 8 week treatment of risperidone [(2 7±0 8) mg/d], 11 patients were re measured Results (1) The patient′s radioactive ratios (RAR) in left frontal lobe (0 85±0 11) was lower than the right frontal lobe (0 86±0 10; P =0 013) Compared with the normal controls, the patient′s in the left frontal lobe, left parietal lobe, bilateral inferior temporal lobe and basal ganglia ( P <0 05), and right thalamus ( P <0 01) were significantly lower The memory quotient and scores of most WMS items, total score of MMSE of patients were significantly lower than that of normal controls (2) After the treatment, the RARs in all the interested regions of the patients and some cognitive impairments were not significantly improved Conclusions The left hypofrontality and memory impairment are existing in late onset schizophrenia And the hypofrontality and cognitive deficits are not significantly improved with the treatment of risperidone更多还原