摘要

[摘要]
目的 探讨不同性别及年龄分层的首发精神分裂症（first-episode schizophrenia，FES）患者颅脑磁共振成像（magnetic resonance imaging，MRI）特征差异，为精神科临床早期识别与分层干预提供影像学依据。

方法 选取92例FES患者作为研究组，90例健康志愿者作为对照组，均行颅脑MRI检查。比较两组颅脑MRI特征差异，并按性别（男/女）和年龄（青年组18～35岁/中年组36～55岁）对研究组进行亚组分析。

结果 与对照组相比，FES患者全脑灰质体积、双侧海马及杏仁核体积显著减小，侧脑室宽度显著增宽（P<0.05）。男性患者灰质萎缩、侧脑室增宽程度显著重于女性（P<0.05）；青年患者灰质及边缘系统萎缩程度显著重于中年患者，而中年患者侧脑室增宽更显著（P<0.05）。

结论 FES患者存在明确的颅脑结构异常，且具有性别和年龄差异，这些影像学特征可为精神科临床早期诊断及分层干预提供客观依据。

关键词：[关键词] 首发精神分裂症；性别；年龄分层；颅脑MRI；影像学特征

ABSTRACT

[Abstract]
Objective To investigate the differences in cranial magnetic resonance imaging (MRI) characteristics among first-episode schizophrenia (FES) patients stratified by gender and age, and to provide imaging evidence for early identification and stratified intervention in psychiatric clinical practice.

Methods A total of 92 FES patients were selected as the study group and 90 healthy volunteers as the control group. All participants underwent cranial MRI scanning. The cranial MRI features were compared between the two groups, and subgroup analyses were performed in the study group according to gender (male/female) and age (young group: 18–35 years; middle-aged group: 36–55 years).

Results Compared with the control group, FES patients showed significantly decreased volumes of whole-brain gray matter, bilateral hippocampus and amygdala, and significantly enlarged lateral ventricle width (P<0.05). Male patients presented more severe gray matter atrophy and lateral ventricle enlargement than female patients (P<0.05). Young patients had more significant atrophy of gray matter and limbic system than middle-aged patients, whereas middle-aged patients showed more obvious lateral ventricle enlargement (P<0.05).

Conclusion   FES patients present distinct cranial structural abnormalities with gender- and age-related differences. These imaging features can provide objective evidence for early diagnosis and stratified intervention in psychiatric clinical practice.

Key words: [Key words] First-episode schizophrenia; Gender; Age stratification; Cranial MRI; Imaging characteristics