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目的探讨儿童精神分裂症患者微小躯体异常(MPAs)与脑室扩大的关系。方法对168例儿童精神分裂症患者(患者组)进行躯体异常量表(WS)评定,并将患者分为 MPAs 明显组(WS总分≥4分,85例)和 MPAs 不明显组(WS 总分≤3分,83例)。用阳性和阴性症状量表(PANSS)评定患者组的精神症状;用 CT 测量患者的脑室(脑室值用哈氏值、三脑室宽度、脑室指数、侧脑室体部指数、侧脑室宽度指数、前角指数表示),并与40名健康儿童(对照组)进行对照。结果(1)患者组哈氏值[(5.37±0.53)cm]和三脑室宽度[(3.83±1.21cm)]均大于对照组[分别为(4.94±0.34)cm和(3.16±0.41)cm],脑室指数(1.55±0.18)和前角指数(3.52±0.31)小于对照组(分别为1.65±0.22和3.77±0.34),均 P<0.01。(2)MPAs 明显组哈氏值[(5.50±0.54)cm]和三脑室宽度[(4.10±1.32)cm]大于 MPAs 不明显组[分别为(5.24±0.49)cm 和(3.55±1.01)cm]和对照组,前角指数(3.47±0.30)小于 MPAs 不明显组(3.57±0.31)和对照组,脑室指数(1.55±0.18)小于对照组。(3)MPAs 不明显组哈氏值大于对照组,脑室指数和前角指数小于对照组,均 P<0.01和 P<0.05。(4)患者组 WS 总分与哈氏值(r=0.263)及三脑室宽度(r=0.287)存在正相关,与前角指数存在负相关(r=-0.178);患者组的 WS 总分与阴性症状分呈正相关(r=0.247);患者组的阴性症状分与哈氏值(r=0.375)和三脑室宽度(r=0.161)呈正相关,与脑室指数(r=-0.159)和前角指数(r=-0.191)呈负相关(均 P<0.01和 P<0.05)。结论儿童精神分裂症患者存在显著的 MPAs 和脑室扩大,MPAs 与脑室扩大之间有明显的相关。
Objective To investigate the relationship between minor somatic abnormalities (MPAs) and ventricular enlargement in children with schizophrenia. Methods A total of 168 children with schizophrenia (patient group) were assessed by somatosensory scale (WS). The patients were divided into MPA group (WS score ≥4 points, 85 cases) and MPAs group Points ≤ 3 points, 83 cases). The patients’ psychiatric symptoms were assessed using the Positive and Negative Symptom Scale (PANSS); the ventricular volume was measured by CT with Haugh’s value, third ventricle width, ventricular index, lateral ventricular mass index, lateral ventricular width index, Angle index), and compared with 40 healthy children (control group). Results The Hash value [(5.37 ± 0.53) cm] and the width of the third ventricle (3.83 ± 1.21 cm) in the control group were significantly higher than those in the control group (4.94 ± 0.34 cm and 3.16 ± 0.41 cm, respectively) (1.55 ± 0.18) and anterior angle index (3.52 ± 0.31) were lower than those of the control group (1.65 ± 0.22 and 3.77 ± 0.34, respectively), both P <0.01. (2) The mean Hb value [(5.50 ± 0.54) cm] and the third ventricle width [(4.10 ± 1.32) cm] in MPAs group were significantly higher than those in MPAs group [(5.24 ± 0.49) cm and (3.55 ± 1.01) cm ] And control group. The anterior horn index (3.47 ± 0.30) was less than that of the MPAs with no obvious group (3.57 ± 0.31) and the control group. The ventricular index (1.55 ± 0.18) was smaller than that of the control group. (3) The Hb value of MPAs in the unobvious group was larger than that in the control group, and the ventricular index and anterior horn index were less than those in the control group, both P <0.01 and P <0.05. (4) There was a positive correlation between total score of WS and Haugh’s value (r = 0.263) and third ventricle width (r = 0.287), negative correlation with rake index (r = -0.178) (R = 0.247). There was a positive correlation between the negative symptoms and the Hirschskih value (r = 0.375) and the third ventricle width (r = 0.161) Angular index (r = -0.191) was negatively correlated (all P <0.01 and P <0.05). Conclusion There are significant MPAs and ventricular enlargement in children with schizophrenia, and there is a clear correlation between MPAs and ventricular enlargement.