摘要目的 研究首发精神分裂症患者的事件相关电位(ERP)变异与临床症状和治疗的关系,探讨变异性质及相关机制.方法 对来自2007年9月至2015年3月在上海交通大学医学院附属精神卫生中心门诊和住院的85例首发精神分裂症患者(患者组)和同期78名健康成人(健康对照组)作了ERP检测.并用阳性和阴性症状量表(PANSS)评定患者精神症状.患者组于治疗1、2和3年进行ERP随访.结果 (1)与健康对照组相比,患者组PPI抑制率降低(41％±37％比68％±42％,P＜0.001)、P50的S2/S1增高(87 ±41比51 ±47,P＜0.001)以及彩图N400潜伏期在Cz脑区明显延迟,波幅较健康对照组低(P ＜0.05 ～0.01).(2)彩图N400潜伏期与PANSS一般状况分(r=0.321,P=0.042)、波幅变化与阳性症状分(r=-0.437,P=0.008)及总分(r=-0.392,P=0.023)之间有相关性.(3)患者组在治疗后的1、2和3年随访时,彩图N400潜伏期和波幅差异有统计学意义(P ＜0.05 ～0.01),但PPI和P50随访主要指标差异无统计学意义(P＞0.05).结论 随访提示PPI和P50变异很可能是本病的属性标志,彩图N400变化是状态标志.

abstractsObjective To investigate the relationship between the variations of event-related potentials (ERP) and clinical symptoms and treatment in first episode schizophrenia patients.Methods The ERP (P50,color map of N400 and prepulse inhibition of the startle reflex (PPI)) were tested in 85 first episode schizophrenia (FES) patients and 78 normal controls (NC),and followed-up at 1,2 and 3 years after treatment in FES.Positive and negative symptom scale (PANSS) was used to evaluate the psychotic symptoms of patients.Results (1) Compared with NC,FES showed decreased PPI％ (41％ ± 37％ vs 68％ ±42％,P ＜0.001),increased P50 S2/S1 (87 ±41 vs 51 ±47,P ＜0.001),prolonged N400 latency and decreased N400 amplitudes (P ＜ 0.05-0.01).(2) Significant correlations were found between variations of color map of N400 latencies and general scores of PANSS (r =0.321,P =0.042),N400 amplitude and positive symptom scores (r =-0.437,P =0.008) and total scores of PANSS (r =-0.392,P =0.023),but the variations of PPI and P50 latencies and amplitudes did not show significant correlation with the positive symptom scores and total scores of PANSS.(3) The color map of N400 latencies and amplitudes in FES group showed significant difference (P ＜ 0.05) but the major indexes of PPI and P50 did not show significant difference (P ＞ 0.05) among the 1,2 and 3 years' follow-up after treatment.Conclusion This follow-up study suggests that the variations of PPI and P50 is probably a trait marker of FES,and the variations of color map of N400 might be a status marker of FES.