伴迟发性运动障碍的慢性精神分裂症病人认知功能状况分析

骆祥芬; 储辉; 王升; 吴延海; 崔明; 宋红梅

doi:10.13898/j.cnki.issn.1000-2200.2020.02.033

伴迟发性运动障碍的慢性精神分裂症病人认知功能状况分析

Analysis of the cognitive function in chronic schizophrenic patients complicated with tardive dyskinesia

摘要

摘要:
目的探讨伴迟发性运动障碍（tardive dyskinesia，TD）的慢性精神分裂症病人认知状况。
方法选取2017年12月至2018年9月蚌埠市精神卫生中心符合疾病和有关健康问题的国际统计分类第十次修订本（ICD-10）中精神分裂症诊断标准的住院病人300例，首先采用Simpson迟发性运动障碍评定量表（Tardive Dyskinesia Rating Scale，TDRS）进行筛选，根据筛选结果分为伴TD组（43例）和不伴TD组（40例），再用异常不自主运动评定量表（AIMS）评定TD组病人异常不自主运动的严重程度，同时运用RBANS对2组病人的认知功能进行测评。
结果除视觉广度外，伴TD组即刻记忆、言语功能、注意、延时记忆得分及RBANS量表总分均明显低于不伴TD组（P < 0.01）。Spearman相关性分析显示，伴TD组AIMS总分与言语功能呈负相关（P < 0.01），年龄与言语功能呈负相关（P < 0.05），文化程度与即刻记忆、视觉广度、延时记忆及RBANS总分呈负相关（P < 0.01）；人口学相关资料与RBANS各因子的多元线性回归分析显示，年龄、文化程度、总病程、住院次数等因素对伴TD的精神分裂症病人认知功能损害有影响（P < 0.05~P < 0.01）。
结论伴TD的慢性精神分裂症病人年龄更大、病程更长、认知功能损害更严重，特别是记忆、言语功能、注意方面，其损害受年龄、文化程度、总病程、住院次数等因素的影响。

Abstract:
ObjectiveTo investigate the influencing factors of cognitive impairment in schizophrenic patients complicated with tardive dyskinesia(TD).
MethodsThree hundred patients with chronic schizophrenia diagnosed by ICD-10 diagnostic criteria, in Bengbu Mental Health Center from December 2017 to September 2018, were investigated.The Simpson Tardive Dyskinesia Rating Scale was used to screen the cases, and the patients were divided into the TD group(43 cases) and non-TD group(40 cases).The severity of abnormal involuntary movement in TD group was evaluated using AIMS, and the cognitive function in two groups were evaluated using RBANS.
ResultsApart from the visual breadth, the scores of the immediate memory, speech function, attention, delayed memory and total score of the RBANS scale in TD group were significantly lower than those in non-TD group(P < 0.01).The results of Spearman correlation analysis showed that the total score of AIMS in TD group was negatively correlated with speech function(P < 0.01), the age was negatively correlated with speech function(P < 0.05), and the degree of education was negatively correlated with immediate memory, visual breadth, delayed memory and total score of the RBANS(P < 0.01).The results of multiple linear regression analysis of demographic data and RBANS factors showed that the age, degree of education, total course of disease, number of hospital stay and other factors had an effect on the cognitive impairment of schizophrenic patients complicated with TD(P < 0.05 to P < 0.01).
ConclusionsThe chronic schizophrenic patients complicated with TD have older age, longer course of disease, more severe impairment of cognitive function, and especially the impairment of memory, speech function and attention are affected by age, education level, total course of illness and number of hospital stay.

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