基于因子分析和聚类分析的首发精神分裂症认知障碍亚型探究

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摘要 目的: 针对首发精神分裂症认知功能障碍进行基于数据驱动的亚型分组，探索不同亚型患者独立认知维度的损伤差异。方法: 采用计算机自动化成套剑桥神经认知测试对253例首发精神分裂症患者和293例健康对照者进行神经认知功能评估，用因子分析方法分离不同的认知维度，并据此对首发精神分裂症患者进行聚类分析，结合阳性和阴性症状量表以及大体功能评定量表评估患者的临床症状，探索不同认知亚型首发精神分裂症的认知损伤机制及临床特征。结果：首发精神分裂症患者和健康对照者的神经认知功能可分成7个维度。据此使用聚类分析，将首发精神分裂症分成低功能和高功能两个不同认知亚型，不同亚型间各个认知维度和临床症状均有显著差异（P<0.01）。与健康对照者相比，低功能组表现出更为严重且广泛的认知功能下降，高功能组则相对保留了抑制功能，其他认知维度的受损介于低功能组和健康对照之间。结论： 首发精神分裂症存在不同认知亚型，抑制功能在不同亚型患者中受损情况不同，可能是识别首发精神分裂症不同认知亚型的核心标志。

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	胡安然
	曾金坤
	何韬
	姚霞
	邓伟

关键词 ：首发精神分裂症, 认知功能障碍, 异质性, 亚型, 聚类分析

Abstract：

Objective: Data-driven subtype grouping was conducted for cognitive impairment in the first-episode schizophrenia and subsequently explored the damage differences of independent cognitive dimensions in patients with different subtypes. Methods: The neurocognitive functions in 253 first-episode schizophrenia patients and 293 healthy controls were evaluated by the Cambridge Neuropsychological Test Automatic Battery (CANTAB). Then, different cognitive dimensions were extracted by factor analysis, and cluster analysis was carried out to group patients with first-episode schizophrenia. At the same time, psychopathological symptoms and the social professional function of the patient group were evaluated by the Positive Negative Syndrome(PANSS) and the Global Assessment Function(GAF) to explore the cognitive impairment mechanism and clinical characteristics of different cognitive subtypes. Results: The neurocognitive functions of the first-episode schizophrenia and the normal control could be divided into seven separable dimensions. Two hundred and fifty-three first-episode schizophrenics were divided into two subgroups: low-function group and high-function group. There were significant differences in cognitive function and clinical symptoms between different subgroups(P<0.01). Compared with the normal controls, the low-function group showed a more severe and extensive cognitive decline, while the highfunction group retained relatively inhibitory function, and the impairment of other cognitive dimensions was between the low-function group and the healthy controls. Conclusion: There are different cognitive subtypes of schizophrenia, and the impairment of inhibitory function is different in different subtypes of schizophrenia, which may be the core marker to identify different cognitive subtypes of first-episode schizophrenia.

收稿日期: 2020-04-30

基金资助:国家重点研发计划项目( 2016YFC1307200)；四川省科技计划应用基础研究(2019YJ0080); 国家老年疾病临床医学研究中心(四川大学华西医院)项目(Z2018A06)

通讯作者: 邓伟(通讯作者)，教授，博士生导师，E-mail: mrdengwei@163.com

作者简介: 胡安然(1993—)，女，硕士研究生

引用本文:

胡安然，曾金坤，何韬，姚霞，邓伟. 基于因子分析和聚类分析的首发精神分裂症认知障碍亚型探究[J]. 江苏大学学报:医学版, 2020, 30(05): 445-450. HU An-ran, ZENG Jin-kun, HE Tao, YAO Xia, DENG Wei.

Subtype identification of cognitive impairment in first-episode schizophrenia based on factor analysis and cluster analysis

. Journal of Jiangsu University(Medicine Edition), 2020, 30(05): 445-450.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2020/V30/I05/445

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