摘要
目的:探讨慢性精神分裂症患者常用代谢指标对认知功能的影响.方法:选取符合国际疾病分类第 10 版(ICD-10)诊断为精神分裂症的慢性患者 99例,检测血尿酸、胱抑素C、糖化血红蛋白、维生素B12、叶酸、同型半胱氨酸、三酰甘油、总胆固醇、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇,用阳性与阴性症状量表(PANSS)评估精神症状,用重复性成套心理状态测验(RBANS)评估认知功能,用多元线性回归分析代谢指标对认知功能的影响.结果:慢性精神分裂症患者同型半胱氨酸水平高于正常范围.尿酸与RBANS的视觉广度和言语功能相关(r=0.215 和r=0.285,均P＜0.05).维生素B12 与RBANS的视觉广度和总分相关(r=0.250 和r=0.201,均P＜0.05).叶酸与RBANS的注意力相关(r=0.228,P＜0.05).同型半胱氨酸与RBANS的即刻记忆、延迟记忆和总分负相关(r=-0.327、r=-0.264 和r=-0.296,均P＜0.01).多元线性回归分析显示同型半胱氨酸是影响慢性精神分裂症患者认知功能的因素.结论:高于正常范围的同型半胱氨酸影响慢性精神分裂症患者的认知功能,治疗中应将相关代谢指标维持在正常范围.
Abstract
Objective:To investigate the influence of common metabolic indicators on cognitive function in patients with chronic schizophrenia.Methods:Ninety-nine chronic patients diagnosed as schizophrenia according to the international classification of diseases 10th edition(ICD-10)were selected to measure the following metabolic indicators:blood uric acid,cystatin C,glycated hemoglobin,vitamin B12,folate,homocysteine,triglycerides,total cholesterol,HDL-C,and LDL-C,the positive and negative syndrome scale(PANSS)was used to assess the psychiatric symptom,cognitive function was tested with the repeatable battery for the assessment of neuropsychological status(RBANS),and the impact of the metabolic indicators on cognitive function was analyzed with multiple linear regression analysis.Results:Homocysteine level was high in the normal range in the chronic schizophrenia patients.Uric acid was related to visual breadth and verbal function of RBANS(r=0.215,and r=0.285,P<0.05).Vitamin B12 was correlated with visual breadth and RBANS total score(r=0.250,r=0.201,P<0.05).Folate was correlated with attention of RBANS(r=0.228,P<0.05).Homocysteine was negatively correlated with immediate memory,delayed memory and the total score(r=-0.327,r=-0.264,and r=-0.296,P<0.01).Multiple linear regression analysis revealed the homocysteine was the factor of on cognitive function in patients with chronic schizophrenia.Conclusion:Elevated levels of homocysteine beyond the normal range have an impact on the cognitive function of patients with chronic schizophrenia,and in the treatment,the related metabolic indicators should be remained within the normal range.
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