目录
英文缩略词表 (1)
中文摘要 (2)
英文摘要 (4)
正文 (6)
前言 (6)
研究问题和假设 (13)
研究意义 (13)
对象与方法 (14)
结果 (16)
讨论 (18)
结论 (20)
研究工作的进一步设想 (20)
参考文献 (22)
附件 (27)
附录 (32)
个人简介 (32)
致谢 (34)
综述 (35)
综述参考文献 (41)
4
英文缩略词表
CCMD-3 Chinese Diagnostic Criteria for Mental Disorder-3 中国精神疾病诊断标准第3版PANSS Positive and Negative Syndrome Scale 阳性与阴性症状量表
MMSE the mini-mental state examination 简明精神状态量表
ITAQ Insight and Treatment Attitude Questionnaire 自知力与态度问卷
LBT Line Bisection Test 线段等分试验 NBT Number Bisection Test 数字等分试验 MNL the mental number line 心理数字线
USN unilateral spatial neglect 单侧空间忽视
中文摘要
目的:忽视是指患者对脑损伤对侧空间刺激不能注意、报告和表征的一种临床综合症,研究表明,左右大脑的半球损伤均能引起忽视症状,右侧大脑半球损伤忽视发病率较高,并且更加严重和持久。而
认知功能障碍,包括注意障碍,是精神分裂症患者的核心表现,这可能与大脑半球的结构和功能异常有关。线段和数字等分试验作为评估忽视现象的有效手段,近来被用于精神分裂症患者空间注意障碍的研究,但目前的研究结果存在不一致。本研究拟采用线段等分和数字等分试验,对精神分裂症患者进行检测,以探讨精神分裂症的空间注意障碍及其与脑半球功能关系。
方法:对象为51名门诊和住院精神分裂症患者及55名年龄、性别、文化程度相匹配的健康者。实验一,线段等分试验:要求被试标出2-20cm十条长度不等线段的中点,统计出各线段的偏移率和十条线段的平均偏移率。实验二,数字等分试验:被试听取跨度固定的两个数字,跨度分别为3(如1和3),5(如1和5),7(如1
和7)和9(如1和9),被试者要求在不进行计算的前提下回答出位于两数字正中间的数字,分别计算出各跨度中点偏移率和四种跨度的平均偏移率。比较患者与健康对照者线段等分偏率和数字等分偏移率。
结果:实验一:患者组所有线段偏移率均为负值,其中平均偏移率(-0.02± 0.03)%和线段2cm偏移率(-0.03±0.74)%与对照组[分别为(-0.00±0.01)%和(0.00±0.02)%]比较,差异有显著性统计学意义(均P<0.05);患者组平均偏移率与零值比较,差异有显著统计学意义(P<0.01);正常对照组的平均偏移率为负值,与零值比较差异有显著统计学意义(P<0.05)。实验二:患者组数字等分偏移
率均为负值,除间距3外,间距5(-0.07±0.18)%、7(-0.08±0.22)%和9(-0.09±0.28)%的偏移率均较对照组[分别为(-0.01±0.05)%、(0.01± 0.08)%和(0.00±0.14)%]
左偏,差异有显著性统计学意义(均P<0.05)。
结论:精神分裂症患者线段等分试验各线段偏移率均为负值,且平均偏移率和多数线段偏移率与零值相比存在显著差异,总平均偏移率较对照者左偏,表明患者空间注意容易忽视线段的右侧;数字等分试验中,患者的中点数字5、7、9的偏移率均为负值,与正常对照者间存在显著差异,同样提示存在右侧忽视现象。实验结果反应了患者总体表现为右侧空间的注意缺陷,可能与左侧脑半球功能障碍有关。
关键词精神分裂症线段等分数字等分忽视
A study of line bisection and number bisection in
patients with schizophrenia
ABSTRACT
Objective Neglect is a clinical syndrome that patients c an’t notice, report and characterize the stimul
ation which from the contralateral space of injury-brain. The studies have shown that the injuries of both brain hemispheres can lead to neglect symptoms, but more serious symptoms, higher frequences and longer period of neglect were found on the right hemisphere danage than the lef one. Cognitive dysfunction including attention deficit is the core feature of schizophrenia, it may relate to the structural and functional abnormalities of the hemispheres. The line and number bisection test, for evaluating the neglect phenomenon have been used in the study of spatial-attention disorder of pateints with schizophrenia, but the results is not consistent. This study will use the Line Bisection Test (LBT) and the Number Bisection Test (NBT) to explore spacial attentional deficits and its relationship to hemisphere in patients with schizophrenia.
Methods 51 schizophrenia patients and 55 age, sex and education-matched healthy controls were meatured with LBT and NBT. .In the line bisection test, all subjects were asked to mark the mid-point of 2-20cm length of the ten line segments and each line deviation rates and the mean deviation rate were caculated. In the number bisection test, participants heard two numbers with fixed number intervals,for wich the size of the interval could be 3 (for example, 1-3), 5 (for example, 1-5), 7 (for example, 1-7) and 9 (for example, 1-9). All participants wre asked to answer the midpoint number and each number deviation rates and the mean deviation rate were caculated.
Results In the line bisection test, shcizophrenic patients showed a negative deviation,