摘要

【摘要】
目的 研究慢性精神分裂症患者认知损害特征对社会功能的影响，为精神康复提供理论依据。

方法 选取男性精神分裂症患者78例及健康对照组70例，完成一般情况调查表、重复性神经心理状态测验 (Repeatable Battery for the Assessment of Neuropsychological Status，RBANS) 及个人和社会功能量表（Personal and Social Performance scale，PSP）测评，研究组同时采集晨空腹血检测血糖和血脂。

结果 研究组RBANS各因子及总分和PSP分均低于健康对照组（P＜0.01）；受教育年限≤9年组即刻记忆、言语功能、注意及RBANS总分均低于受教育年限＞9年组（P＜0.01或P＜0.05）；病程≤15年组即刻记忆、注意、延时记忆及RBANS总分和PSP分均高于病程＞15年组（P＜0.01或P＜0.05）；糖脂代谢异常组即刻记忆、视觉广度、注意、延时记忆及RBANS总分均低于糖脂代谢正常组（P＜0.01）。Pearson相关分析显示，患者PSP分与RBANS各因子分及总分呈正相关性（P＜0.01）。多元逐步回归分析进一步显示，RBANS总分、病程及视觉广度可以影响患者社会功能。讨论 慢性精神分裂症记忆功能、视觉广度、言语功能、注意等认知领域均存在不同程度的损害。患者受教育程度越低，病程越长，记忆及注意方面损害程度越严重。合并糖脂代谢异常者记忆、视觉广度及注意等认知损害相对更重。认知功能与社会功能关系密切，视觉广度、总体认知水平及病程是社会功能的影响因素。

关键词：慢性精神分裂症；认知；社会功能；影响因素

ABSTRACT

【Abstract】
Objective To study the cognitive characteristics of patients with chronic schizophrenia and its impact on social functioning, so as to provide a theoretical basis for mental rehabilitation.

Methods A total of 78 male patients with schizophrenia and 70 healthy controls were selected, and the General Condition Questionnaire, Repeatable Battery for the Assessment of Neuro-psychological status(RBANS) and the Personal and Social Performance scale(PSP)were completed.The study group also collected morning fasting blood to detect blood glucose and blood lipids.

Results The RBANS factors, total score and PSP score of the study group were significantly lower than those of the healthy control group (P<0.01)；The scores of immediate memory, language, attention and the visuospatial/constructional subsections and the total score of RBANS in the ≤9-year group were lower than those in the >9-year group (P<0.01 or P<0.05)；The scores of immediate memory, attention, the delayed memory subsections and the total score of RBANS and PSP in the ≤15-year group were lower than those in the >15-year group (P<0.01 or P<0.05)；The scores of immediate memory, visual span, attention, delayed memory factor and total RBANS in the abnormal glucose and lipid metabolism group were significantly lower than those in the normal glucose and lipid metabolism group (P<0.01). Pearson correlation analysis showed that PSP score was significantly positively correlated with RBANS factors and total score (P<0.01). Multiple stepwise regression analysis further showed that the total score, course of disease and visual span of RBANS could affect the social function of patients.

Conclusion   In chronic schizophrenia, there are varying degrees of impairment in cognitive domains such as memory function, visual span, language, and attention. The lower the level of education and the longer the duration of the disease, the more severe the impairment of memory and attention. Patients with abnormal glucose and lipid metabolism had more severe cognitive impairments such as memory, visual span, and attention. Cognitive function is closely related to social function, and visual span overall cognitive level and disease course are the influencing factors of social function.

Key words: Chronic schizophrenia ; Cognitive function; Social function；Influencing factors