【摘要】 目的探讨儿童期性虐待(CSA)受害者认知障碍的生化机制。方法对某职业学校成人服刑女犯21例CSA受害者(CSA组)和21例同校服刑女犯(对照组)进行威斯康星卡片分类测验(WCST)和韦氏记忆测验,用放射免疫方法检测血浆神经肽Y(NPY)水平,并分析NPY与认知功能、创伤后应激症状(IES-R)的关系。结果(1)CSA组的IES-R总分及闯入因子、麻木/回避因子和高警觉因子3个因子分均高于对照组(P<0·01);(2)CSA组在顺数、倒数、积累、图片、再生、联想、触摸、长时记忆、短时记忆、记忆商数等的评分均低于对照组,而总试验次数和随机错误数则多于对照组(P<0·01和P<0·05);(3)CSA组血浆NPY水平[(73±56)NG/L]低于对照组[(134±53)NG/L;P=0·001];(4)NPY水平与记忆商数(R=0·354)、短时记忆(R=0·385)、再生(R=0·340)、触摸(R=0·328)呈正相关(P<0·05和P<0·01),与WCST各测验分数和IES-R总分无相关(P>0·05)。结论儿童期性虐待受害者的执行功能和记忆明显受损,血浆NPY水平下降可能是其记忆损害的生化机制之一,而创伤后应激症状与血浆NPY水平下降无关。更多还原

【Abstract】 Objective To explore the cognitive functions among female victims with childhood sexual abuse (CSA) and its relationship to the plasma neuropeptide-Y(NPY).Methods Twenty-one victims with CSA and 21 age- and education-matched controls were screened out in female inmates. The Wechsler Memory Scale (WMS), Wisconsin Card Sorting Test (WCST) and the Impact of Event Scale-Revised (IES-R) were administered to them. The plasma NPY was determined with immunoradiometric assay. Bivariate spearman correlations between NPY and cognitive function and IES-R were analyzed.Results The scores of WMS memory quotient (MQ) (85.09±19.15), long-term (25.90±7.36) and short-term (55.55±11.34) memory in CSA group were significantly lower than that in control group (105.57±14.65, P=0.000; 34.47±4.72, P=0.000; 65.01±7.25, P=0.001, respectively). The scores of WCST total trials (92.21±24.40) and random errors (44.79±21.55) in CSA group were significantly higher than that in controls (67.90±19.64, P=0.001; 22.33±14.61, P=0.000, respectively). Plasma NPY level in CSA group was significantly lower than that in controls [(73±56)ng/L vs. (134±53) ng/L; P=0.001]. The NPY level was significantly positively correlated with the MQ (r=0.354, P<0.05), short-term memory (r=0.385, P<0.05), but not related to the WCST parameters or IES-R total score.Conclusion The results indicate the female victim with childhood sexual abuse has memory and execution impairments. The decreased plasma NPY level may play a role in the memory impairment, but not related to the severity of posttraumatic stress symptoms.更多还原