【摘要】 目的探讨脑立体定向手术对难治性精神分裂症患者认知功能和临床症状的影响。方法采用美国Nicolet-bravo多功能脑诱发电位检查仪检查,观察30例难治性精神分裂症患者立体定向手术治疗前后各脑区（Cz、C3、C4、Pz）事件相关电位P₃₀₀的特征变化,并与32例正常组进行比较；采用阴性与阳性症状量表分别对手术组手术前后进行评定。结果术前与正常组比较,手术组事件相关电位P₃₀₀的靶刺激N2（Cz、C3、C4、Pz）、P3（Cz、C3、C4、Pz）、P4（Cz、C4）潜伏期延迟（P＜0．01）,N1（Cz、C3、C4、Pz）、P2（C4）潜伏期缩短（P＜0．01）；靶刺激P3波幅和非靶刺激P2波幅在各个脑区均降低（P＜0．01）。与术前比较,手术组事件相关电位P₃₀₀的靶刺激N1（Cz、C3、Pz）、P2（C3、Pz）、N2（Pz）、P3（Cz 310．7±22．1、C3 314．6±16．3、C4 315．6±9．1、PZ 308．7±13．1）、P4（Pz）和非靶刺激P2（Cz、C3）潜伏期均缩短（P＜0．05或0．01）,而靶刺激P2（C4）潜伏期延迟（P＜0．01）；靶刺激P2（Cz、C3、C4、Pz）、P3（Cz、C3、C4、Pz）波幅和非靶刺激P2（Cz、Pz）波幅均降低（P＜0．01）,靶刺激P4[Cz（2．7±0．6）μv、C3（2．9±1．1）μv、C4（3．0±0．5）μv]波幅升高（P＜0．01～0．05）。与术前相比较,术后手术组PANSS量表各因子（除反应缺乏、抑郁因子）及总分均明显下降（P＜0．05或0．01）。结论脑立体定向手术对各个脑区事件相关电位P₃₀₀产生广泛影响,主要体现为潜伏期的缩短和波幅的降低,并改善精神分裂症症状。更多还原

【Abstract】 Objective To study the effect of stereotaxis on the event related potential P₃₀₀(P₃₀₀)and clin- ical symptoms in patients with refractory schizophrenia.Method 30 cases of patients and 32 normal controls were involved.The cases were studied with P₃₀₀and the Positive and Negative Syndrome Scale（PANSS）before and after treatment.The P₃₀₀was recorded with Nicolet Bravo Instrument.Results Compared with normal group, P3oo of patient group showed decreased amplitude（Target P3 and Non target P2 from Cz,C3,C4,Pz,P＜0.01）, prolonged latency（Target N2 and P3 from Cz,C3,CA,Pz,Target P4 from Cz,C4,P＜0.01）and shortened la- tency（Target N1 from Cz,C3,C4,Pz,Target P2 from C4）.P₃₀₀of patient group show shortened latency of tar- get wave NI（Cz,C3,C4,Pz）,P2（C3,Pz）,N2（Pz）,P3（Cz 310.7±22.1,C3 314.6±16.3,C4 315.6±9.1,Pz 308.7±13.1）,P4（Pz）and non target wave P2（Cz,C3）,prolonged latency of target wave P2 （C4）,decreased amplitude of target wave N1（Cz,C3,Pz）,P2（C3,Pz）,N2（Pz）,P3（Cz,C3,C4,Pz）, P4（Pz）and non target P2（Cz,C3）,and heightened amplitude of target wave P4（Cz 2.7±0.6,C3 2.9±1.1,CA 3.0±0.5）after operation.The total score and factor scores（except reaction lack gene and depression gene）of PANSS were significantly decreased（P＜0.01）after operation in the patients.Conclusion The stere- otaxis towards refractory schizophrenia can far-ranging shorten latency,decrease amplitude of P₃₀₀and improve clinical symptom.更多还原