利培酮治疗对急性未服药精神分裂症患者P50的影响【摘耍】目的:探讨口服利培酮治疗对急性未服药精神分裂症患者听感觉门控P50的影响。方法:共纳入急性未服药精神分裂症患者64例(首发36例，复发28例)，采用可变剂量利培酮治疗,分别于治疗前(基线期)及治疗8周后,釆用听觉条件(S1)-测试(S2)刺激范式进行P50检测，同时使用阳性和阴性症状量表(thePositiveandNegativeSyndromeSeale,PANSS)评定患者精神病理症状;选取与患者性别、年龄、受教育年限匹配的健康人90例，测查P50作为正常对照。结果:①首发患者病程明显短于复发患者,但两者P50各指标无统计学差异。②与对照组相比,患者组(首发与复发合为患者组)基线期P50抑制率比值(S2/S1)升ME(36.0±32.0)%vs.(55.5±48.4)%](非正态分布)、S1波幅降低[(3.4±1.6)mVvs.(2.7±1.6)mV]>SI与S2波幅差(S1-S2)减小[(2・2±l・6)msvs.(1.3±1.3)ms],(P<0.05),其余P50指标差异无统计学意义;③患者组治疗前后的P50各指标无统计学差异(P>o.05);④在基线期患者组P50抑制率(S2/S1)与PANSS阴性量表分呈正相关&二0・43,P=0.001);治疗8周后此相关性消失。结论:精神分裂症患者听感觉门控缺陷可能是精神分裂症稳定的内表型，与病程具有相对的独立性，利培酮难以改善这种缺陷。【关键词】精神分裂症;听感觉门控P50;利培酮;精神病理症状;对照研究中图分类号:R749.305文献标识码:A文章编号:1000-6729(2010)004-0265-05doi:10.3969/j.issn.1000-6729.2010.04.006EffectsofrisperidoneonauditorygatingpotentialP50inacutemedication-freepatientswithschizophreniaYANGGui-Gangl,2,TANYun-Long❷1,YANGFu~De❷1,LIJuan❷1,CHENSong令1,ZHANGJing-Guo❷1,WANGAn-Wen❷1,ZHANGRong-Zhen01,FENGWei❷1,WANGZhi-Ren❷1,ZHANGWu-Fang❷2,ZHOUDong-Feng❷2❷IBeijingHuilongguanHospital,Beijing100096,China❷2InstitudeofMentalHealth,PekingUniversity;KeyLaboratoryofMentalHealth,MinistryofHealth(PekingUniversity),Beijing100191,ChinaCorrespondingauthor:ZHOUDong-Feng,E~mai1:zhoudf@bjmu.省略[Abstract]0bjective:ToinvestigatetheeffectsofrisperidoneonsensorygatingpotentialP50inacutemedication-freeschizophrenics・Methods:Sixty-fouracutemedication-freeschizophrenics(ineluding36first-episodeand28recurrentones)wererecordedofP50andwereevaluatedoftheirpsychopathicsyndromeswiththePositiveandNegativeSyndromeScale(卩ANSS)beforeandafter8weeksofmedicationwithoralrisperidone・Andanother90healthypersons5P50werecollectedasnormalcontroldata・Results:(1)TherewasnosignificantdifferenceofP50betweenthefirst-episodeandrecurrentschizophrenicsregardlesstheformerhadshorterpsychiatriccoursethanthelater・(2)Comparingwiththenormalgroup,thepatients(first-episodeandrecurrentpatientswerecombinedonegroupwholly)showedhigherP50suppressionratios(S2/S1)[(36.0±32.0)%vs.(55.5±48.4)%,P<0.05],lowerSIamplitude[(3.4土1.6)mVvs.(2.7+1.6)mV]andlessamplitudedifference(S1-S2)[(2.2±1.6)msvs.(1.3±1.3)ms].(3)TherewerenosignificantdifferencesofP50indicesinpatientspre-andafterrisperidoneadministered・⑷Therewaspositivecorrelationbetweenthepatients'P50suppressionratiosandthescoreofNegativeSyndromesubscaleofPANSS(r=0.43,P=0.001).Butafter8-weektreatment,nocorrelationwasfoundanymore・Conclusion:Theresultsindicatethatinschizophrenicstherearesensorygatingdysfunctionswhichmaybenotrelatedtopsychiatriccoursedirectly,andcouldnotbenormalizedbymedicationwithrisperidone・［Keywords】schizophrenia;auditorysensorygatingP50;risperidone;Psychopathicsyndrome;controlstudy自1982年Adler等［1］报道精神分裂症患者存在听感觉门控P50缺陷以来,测量中潜伏期事件诱发电位(event-relatedpotential,ERP)P50成为研究精神分裂症的新热点oHeinrichs等［2］对以往研究进行了荟萃分析，结果显示,P50抑...