• P136
  Pay More Attention to Personality Disorder of Children
  Hong Chen 1 , Jie Ya Chen 2
  1 World Federation of Chinese Medicine Societies, Beijing , Chinese Mainland, 2 Haidian third Experimental Primary School , Beijing , Chinese Mainland
  

  Objectives: It's better to pay more attention to personality disorder of children than to adults later on.
  Methods: Young people are adaptable,adults (no matter how smart they may be)are at the age where people become more set in their ways, and are accustomed to things being done in a certain way, and generally are reluctant to bend their minds in ways they are not patterned to. Parents and school teachers should be co-operated with psychiatrists in order to solve this problems well. Baby's mind has different power from adult, and has huge creation. Baby's body has to prepare for the development of his intelligence,and all of these great work are done in the situation of unconsciousness, children can absorb knowledges directly by mental energy. Children establish their spirit through the environment arround them. Humanbeings develop their mental ability first, organs are developed later and controled by mental power. The most important development of humanbeing is mental development. Because all the behavior are supposed to be directed and controled by spirit. So children's personality disorder could be solved easier than adults,we must pay more attention to them!
  Results: Personality Can be manufactured, especially for children. Children have strong ability to imitate. If we put the child who has personality disorder to the formal children together for a period of time,he or she can change the bad personality totally.
  Conclusions: Personality Disorder is very common in the world and it really needs to be solved. Research work shows it is more easier to solve personality disorder of children than adults.By Buddhism or Taoism, mind works unconsciousness just like baby. In mind there is nothing but everything. The mind in this situation works in the faster way but uses the lower energy of body,full of intelligence of cause. These abilities belong to unconscious mental power, and turn to be conscious only by the experiment through environment arround.
   
  
• P137
  100 例精神分裂症患者 脑供血情况与听觉事件相关诱发电位相互关系的研究 - Cerebral Blood Flow and Auditory P300 in 100 Schizophrenia Patients
  毅 龚 1
  1 昆明市精神病院 , 昆明 , Chinese Mainland
  
  目的 ： 探 讨精神分裂症患者脑供血情况与其认知功能之间的相互关系 ， 为 找出精神分裂症患者 认知功能受损的原因提供理论依据 ， 并指导临床治疗。
  方法 ： 选取符合入组条件的精神分裂症患者 100 名 ， 对其进行听觉事件相关诱发电位 （ p300 ） 检查以评价其认知功能 ； 对认知功能检查评价为 “ 差 ” 和 “ 极差 ” 的患者 进行经颅多普勒脑血流图 （ TCD ） 的 检查 ， 记录血流峰值及脉动指数以了解其脑供血情况。
  结果 ： 100 名精神分裂症患者 P 300 检查提示有 83 名 认知功能为 “ 差 ” 到 “ 极差 ” 占 83 ％， 这 83 名患者的 TCD 检查结果显示大脑中动脉脉动指数为 ： 0.89±0.24 ； 大 脑前动脉脉动指数为 ： 0.86±0.12 ， 均 显著高于我国正常成人常模。
  结论 ： 精神分裂症患者的 认知功能普遍较差 ， 可能与其大脑中动脉、大脑前动脉血管舒缩调节功能下降而导致大脑前额叶供血不足有关。
   
  
• P138
  复发性精神分裂症伴有上呼吸道感染的调查分析 - A Survey of Recurrent Schizoprenia with Upper Respiratory Infectious Disease
  存安 胡 1
  1 西安安定医院 （ 陕西省西安市 ） , 精神科 , 西安市 , Chinese Mainland
  
  目的 ： 调查和探讨上呼吸道感染与精神分 裂症 复发间的内在关系 ， 为临床治疗提供资料。
  方法 ： 调查统计复发性精神分裂症在入院时伴有上呼吸道感染的病例 ， 并根据目前的有关研究结果进行分析探讨。
  结果 ： 复发性精神分裂症中有 40.7% （ 22/54 ） 的病例在入院 时伴有上呼吸道感染。因免疫反应的改变也会导致脑功能的改变，这种变化导致某些脑基因表达的变化，从而诱发一些精神分裂症的复发。
  结论： 感染因素（特 别是病毒感染）是复发性精神分裂症复发的重要诱发因素之一。对伴有上呼吸道等感染的患者要及时治疗。
   
  
• P139
  门诊首发分裂症用药情况分析 - Drug Use of First-episode Schizophrenia in Out-patient Clinic Service
  传福 宋 1 , A10
  1 芜湖市第四人民医院 , 芜湖市 , Chinese Mainland
  
  目的 : 了解 门诊首发精神分裂症患者首次用药情况 ; 方法 : 采用自行 设计的调查表对 1995 年 1 月 ~10 月、 2000 年 1 月 ~10 月及 2005 年 1 月 ~10 月在 门诊首次治疗的首发精神分裂症患者用药及一般资料进行调查 ;
  结果 : 1995 年共有 158 例，其中 单用抗精神病药物（ APD ） 142 例（ 89.87% ） , 以 氯氮平为首；联合用 APD16 例（ 10.13% ），以 氯氮平联合舒必利为首；预防性应用安坦 18 例（ 11.39% ）；合用苯二氮卓 类药物（ BZD ） 20 例（ 12.66% ）。 2000 年共有 180 例，其中 单用 APD133 例（ 73.98% ），以利培 酮为首；联用 APD47 例 (26.11%), 以 氯氮平联合舒必利为首；预防性应用安坦 23 例 (12.78%); 合用 BZD46 例（ 25.56% ）。 2005 年共有 198 例，其中 单用 APD189 例（ 95.46% ） , 以阿立 哌唑为首；联合用 APD9 例（ 4.54% ），以 氯丙嗪联合阿立哌唑为首；预防性应用安坦 17 例（ 8.59% ）；合用 BZD109 例（ 55.05% ） ;
  结论 : 目前 门诊首发精神分裂症患者首次治疗时单用 APD 以阿立 哌唑为首选，不主张预防性应用安坦，慎用 BZD 。
  
  Objective: To investigate the first use of antipsychotics in the outpatients with first-episode-schizophrenia.
  Method: 158 cases(Jan~Oct1995) 、 180 cases(Jan~Oct2000) and 198 cases (Jan~Oct2005) with first-episode-schizophrenia were included. The antip-sychotics prescription among 536 cases were studied.
  Results: Clozapine 、 Resperidone and Aripiprazole were respectively the most frequently used antipsychotics in 1995 、 2000and in 2005.
  Conclusion: At present, aripiprazole in the most frequently used antipsychotics among outpatients with first-episode-schizophrenia, prophylactic use of artane is not recommended, benzodiazepine drugs should be used carefully.
   
  
• P140
  儿茶酚胺氧位甲基 转移酶 Val/Met 基因多 态性与精神分裂症的关联性研究 - Association Study of Val/Met Polymorphism of Catechol-O-Methyltransferase Gene and Schizophrenia
  梅志 贾 1 , 路 线 吕 2 , 文 强 李 2 , 素芹 郭 2 , 照希 仲 2 , 从 辉 王 3
  1 中国人民解放 军第二六一医院 , 北京 , Chinese Mainland, 2 河南省精神病医院 , 新 乡 , Chinese Mainland, 3 天津市安定医院 , 新 乡 , Chinese Mainland
  
  目的 ： 探 讨儿茶酚胺氧位甲基转移酶 Val/Met 基因多 态性与精神分裂症的关联。
  方法 ： 对 232 例符合入 组标准的精神分裂症患者和 141 例同期健康 对照者进行病例 - 对照研究 ， 采用序列特异性引物 PCR 技 术测定基因型。
  结果 ： 1 COMT 基因 Val/Met 多 态性突变率为 5% ， 该多态性在精神分裂症患者组和正常对照组基因型及基因频率差异无统计学意义 ， 患者组和同性别对照组基因型和基因频率比较无差异显著性 ， 该多态性基因型及基因频率在不同家族史患者组间分布无差异显著性。
  结论 ： COMT 基因第四外 显子区 Val/Met 多 态性与精神分裂症无相关性 ， 与精神分裂症患者性别、家族史亦无关。
  
  [ COMT 基因型 Val/ Met 多 态性的琼脂糖凝胶电泳图 ]
  
  
  Objective ： To explore the relationship between Val/Met polymorphism of catechol-O-methyltransferase (COMT) gene and schizophrenia in Chinese Han people .
  Methods ： 232 Chinese Han patients with schizophrenia and 141 normal control were studied using sequence-special primers PCR amplification (PCR-SSP) technique.
  Results ： 1The mutation rate of COMT gene Val/Met polymorphism was 5%.The frequency of genotype and allele in schizophrenic group was no significant difference compared with control group about the polymorphism of COMT; There was no difference between genotype and gene frequency of the schizophrenic group and that of the same sex control group ； The difference of the genotype and gene frequency between male and female schizophrenic groups hadn't statistics significance; thefrequency of genotype and alleles on different schizophrenia groups classified by family medical history was no significant difference.
  Conclusions ： No association exists between the COMT gene Val/Met polymorphism located in the forth exon and schizophrenia, and Val/Met polymorphism doesn't have association with schizophrenic sex ， family history.
   
  
• P141
  门诊精神分裂症病人社会功能的相关因素研究 - Analysis of Correlated Factors of Social Function for Outpatients with Schizophrenia
  兴兵 黄 1
  1 广州市 脑科医院 , 广州 , Chinese Mainland
  
  目的 探 讨门诊维持治疗的精神分裂症病人社会功能的相关因素。
  方法 : 采用社会功能缺陷 筛选量表 （ SDSS ） 、阳性症状和 阴性症状量表 （ PANSS ） 对 60 例 门诊精神分裂症病人进行评定。
  结果 : （ 1 ） 使用非典型抗精神病 药治疗的病人 ， SDSS 评分要明显低于其他药物治疗组 （ P<0.05 ）； （ 2 ） 相 关分析结果 ， SDSS 评分与年龄、住院时间、阳性症状分、精神病理分均无明显相关性 （ P 均 >0.05 ）； SDSS 分与 PANSS 总分、阴性症状分、住院次数成正相关 （ P<0.05 ）， 与起病年 龄成负相关 （ P<0.05 ）； （ 3 ） 多因素回 归分析显示 ， 影响 SDSS 分的主要因素有两个 ， 即住院次数和 PANSS 阴性症状分。
  结论 : 影响 门诊维持治疗精神分裂症病人社会功能的因素 是多方面的。
  关键词 : 精神分裂症 社会功能 门诊
  
  Objective: To explore the correlated factors for outpatients with schizophrenia at the stage of maintained treatment.
  Method: 60 schizophrenic outpatients were scaled with the Social Disability Screening Schedule (SDSS), the Positive and Negative Symptom Scale (PANSS).
  Results: (1) Scores of SDSS in patients treated with atypical antipsychotics were significantly lower than those treated with other types of drugs （ P<0.05 ） (2) Scores of SDSS were not clearly correlated with ages, hospitalized time, scores of positive symptoms and scores of psychopathology （ P 均 >0.05 ） . And they were positively correlated with the total scores of PANSS, scores of negative symptoms and hospitalized times （ P<0.05 ） . But were negatively correlated with ages of onset （ P<0.05 ） . (3)Regression analysis of multi-factors showed there were mainly two factors (hospitalized time and scores of negative symptoms of PANSS).
  Conclusion: There were multiple factors that influenced the social function of outpatients with schizophrenia at the stage of maintained treatment.
  Key words: schizophrenia social function outpatient
   
  
• P142
  Comparative Trail of Qing Xin Chong Ji-II in the Treatment of First Onset Schizophrenia
  Bai Han 1 , Peishen Bai 1 , Ronghua Tang 2 , Hao Sun 3
  1 Shanxi Medical University, Department of Psychiatry, Taiyuan, Chinese Mainland, 2 Tongji Hospital of Tongji Medical College of Huazhong Science & Technology University, Department of Neurology, Wuhan, Chinese Mainland, 3 Shanxi Provincial Children Hospital, Department of Neurology, Taiyuan, Chinese Mainland
  
  Objective: To evaluate the add-on therapeutic effect of the self-dispense herb formula-Qing Xin Chong Ji -II combined with risperidone in the treatment of schizophrenia and to observe Qing Xin Chong Ji -II effect on reducing side effects of antipsychotics.
  Method: All the subjects were diagnosed as schizophrenia according to the CCMD-3 diagnosis standard and were randomized into 4 groups: the treatment group1 (Qing Xin Chong Ji-II combined with risperidone or olanzapine) and the control group1 without Qing Xin Chong Ji-II; the treatment group 2 (Qing Xin Chong Ji-II combined with sulpiride or clozapine) and the control group 2 without Qing Xin Chong Ji-II; The treatment lasted for 8 weeks. The patients' blood routine, urine routine, blood sugar, blood urea nitrogen, liver function, electrocardiogram, electroencephalogram were tested before and at the 2th 4th, 6th, 8th weeks after the treatment. The Positive and Negative Syndrome Scale (PANSS) were used to evaluate therapeutic effects, and Treatment Emergent Side effect Scale (TESS) was used to estimate side effects respectively before the treatment and at the 2th, 4th, 6th, 8th weeks after the treatment.
  Result: There were no significantly difference of the total efficacy between the treatment groups and the control groups after 8 weeks of treatment （ P ＞ 0.05 ） . The total scores, the scores of positive syndrome 、 negative syndrome and general syndrome of PANSS in the treatment group and the control groups were significantly different before and after 8 weeks (P < 0. 01). It showed that Qing Xin Chong Ji-II could reduce side effects of antipsychotics.
  Conclusion: Qing Xin Chong Ji-II has add-on effect for risperidone and olanzapine in the treatment of schizophrenia, especially effective for the negative symptoms of schizophrenia. It can reduce the side effect rates of ant psychotics and has clinical value in the treatment of schizophrenia.
  Keywords: Qing Xin Chong Ji -II Schizophrenia Efficacy Side effects
   
  
• P143
  Curative Effects of Qing Xin Chong Ji I Hao in Treatment of Schizophrenia
  Bai Han 1 , Peishen Bai 1 , Ronghua Tang 2 , Hao Sun 3
  1 Shanxi Medical University, Department of Psychiatry, Taiyuan, Chinese Mainland, 2 Tongji Hospital of Tongji Medical College of Huazhong Science & Technology University, Department of Neurology, Wuhan, Chinese Mainland, 3 Shanxi Provincial Children Hospital, Department of Neurology, Taiyuan, Chinese Mainland
  
  Objective: To evaluate the add-on therapeutic effect of the self-dispense herb formula-Qing Xin Chong Ji-I combined with risperidone and olanzapine in the treatment of schizophrenia and to observe Qing Xin Chong Ji-I effect on reducing side effects of antipsychotics.
  Method: All the subjects were diagnosed as schizophrenia according to the DSM-IV-R diagnosis standard and were randomized into 4 groups: the treatment group1 (Qing Xin Chong Ji-I combined with risperidone or olanzapine) and the control group1 without Qing Xin Chong Ji-I; the treatment group2 (Qing Xin Chong Ji-I combined with chlorpromazine, haloperidol or perphenazine) and the control group 2 without Qing Xin Chong Ji-I; The treatment lasted for 8 weeks. The patients' blood routine, urine routine, blood sugar, blood urea nitrogen, liver function, electrocardiogram, electroencephalogram were tested before and at the 2th, 4th, 6th, 8th weeks after the treatment. The Positive and Negative Syndrome Scale (PANSS) were used to evaluate therapeutic effects, and Treatment Emergent Side effect Scale (TESS) was used to estimate side effects respectively before the treatment and at the 2th, 4th, 6th, 8th weeks after the treatment.
  Result: There were no significantly difference of the total efficacy between the treatment groups and the control groups after 8 weeks of treatment （ P ＞ 0.05 ） . The total scores, the scores of positive syndrome 、 negative syndrome and general syndrome of PANSS in the treatment group and the control groups were significantly different before and after 8 weeks (P<0.01). It showed that Qing Xin Chong Ji-I could reduce side effects of antipsychotics.
  Conclusion: Qing Xin Chong Ji-I has add-on effect for risperidone and olanzapine in the treatment of schizophrenia, especially effective for the positive symptoms of schizophrenia. It can reduce the side effect rates of ant psychotics and has clinical value in the treatment of schizophrenia.
  Keywords: Qing Xin Chong Ji -I Schizophrenia Efficacy Side effects
   
  
• P144
  Influence of Apolipoprotein E (ApoE) Gene on the Clinical Features of Schizophrenia
  Jianhua Sheng 1 , Mingdao Zhang 1 , Shunying Yu 1 , Shenxun Shi 1 , Zhenhua Song 1 , Dongxiang Wang 1
  1 Shanghai Mental Health Center, Shanghai, Chinese Mainland
  
  Objective: To investigate the influence of apolipoprotein E (ApoE) gene on the clinical features of schizophrenia.
  Method: 100 schizophrenic in-patients, 50 men and 50 women, were genotyped for ApoE gene. The cognitive function was assessed by WAIS, WMS, WCST and the canceling digit test. The psychotic symptoms were assessed by PANSS. The age of onset, the types of diagnosis and the genetic history were also investigated.
  Results: The negative symptom of ε 3+ patients was milder than that of ε 3- patients. The positive symptom of ε 4+ patients was milder than that of ε 4- patients. The frequency of ε 4 was higher in men than in women. The most important findings were that the negative symptom, the impairment of attention and the genetic tendency of ε 4+ schizophrenic women were severer than those of ε 4- schizophrenic women.
  Conclusion: ApoE genotype influences the psychotic phenotype of schizophrenia. ε 4+ schizophrenic women have a worse prognosis than those without.
   
  
• P145
  一位精神分裂症合併強迫症 狀患者之護理經驗 - Nursing Experience of Schizophrenic Patient with Obsessive-compulsive Disorder
  珍 秀 李 1
  1 財團法人奇美醫院 , 護理部精神科 , 台南市 , Taiwan , Province of China
  
  本文在呈現一位精神分裂症合併強迫症 狀患者之護理經驗。在護理過程中，筆者依 Gordon 十一項健康功能型態評估，確立案主的主要問題有思考過程變異、個人及家庭因應能力失調。照護模式以支持性會談為主軸，輔以認知行為治療概念，按治療性人際關係的階段目標分期，依序為：互動前期、介紹期、工作期、結束期，筆者循序漸進由蒐集資料開始，到與案主、家屬共擬治療計劃並執行，成效良好。護理期間經由定期的會談及所建立的護病關係，適時地澄清並修正其非理性信念，配合計劃中的行為日記及生活作息表之進度執行，達到案主能自我監測及減少與家人的衝突。不合宜的行為也有顯著成效，如清洗喉嚨由 每日 4~5 次減少至 0~2 次，吐口水則很少再發生，案主並能將所習得之因應技巧，運用於日常壓力及人際衝突的處理。筆者在照護此案主過程收穫良多 ， 故將此護理經驗與臨床同仁分享。
  
  The study aimed at the nursing experience of a schizophrenic patient with obsessive-compulsive disorder. During nursing, the patient's thinking process variation and the patient's and family's inadequate coping skills were indicated according to Gorden 11-item Functional Health Pattern.The care model main axis was support interviews and assisted by the cognitive behavior. The therapeutic interpersonal relationship was divided accordingly: the preinteraction phase, orientation phase, working phase, and termination phase. The effect was good after the data collection, author- and patient- and patient's family-planned therapy, and implementation.
   
  
• P146
  印度一个市 级精神病院住院的精神分裂症患者的婚姻状况与子女数量调查 - Marital Status and Rates of Reproduction in Schizophrenic Patients Attending in a City Mental Hospital in India
  Asis Krishna Acharya 1
  1 calcutta Pavlov Hospital, Psychiatry, Kolkata, India
  
  目的 ： 早期研究 显示男性精神分裂症患者未婚率高。另有研究（ Eaton 1985, Kallman 1938 ） 显示，女性精神分裂症患者生育数低。原因是长时间住院、服用可能增加催乳素水平的新型抗精神病药物、缺乏情感温暖或与性伴侣关系差。
  方法： 2004-2005 年在加 尔各答市巴甫洛夫 医院住院的 144 名精神分裂症患者 为研究对象，另外匹配 144 名情感障碍患者作 为对照组。 2 组年龄范围都在 30-45 岁，男女均分别为 72 名，先分析他 们的婚姻状况，其后调查已婚患者的子女数。
  结果： 在 144 名依据 DSM-4TR 诊断为精神分裂症的患者中， 72 名男性中有 53 名已婚， 15 名未婚， 4 名离婚或分居（其中 1 人曾有二次婚姻）； 72 名女性中有 60 名已婚， 仅有 2 名未婚， 8 名离婚或分居， 还有 2 名 处于分居状态但未经司法判决。情感障碍患者为主的对照组中，男性中 67 名已婚， 3 名离婚， 2 名未婚；女性中 70 名已婚、 3 名 丧偶、 1 名未婚。 总之，男性精神分裂症组中未婚率很高 (>20%) ，女性精神分裂症 组中未婚率极低 (>3%) 。女性精神分裂症 组中离婚或分居率很高 (15%) ，男性精神分裂症 组中离婚或独居率很低 (>8%) 。非精神分裂症 组中男女已婚率均高 ( 分 别为 >92% 和 95%) ，离婚或分居率均很低，男性 为 4% ，女性 为 0 。精神分裂症男性的子女数 较少， >15% 的患者的子女数 为 0 ，大多数（ 55% ）患者有 1 个孩子， 20% 有 2 个孩子， 仅 12% 有 2 个孩子以上。女性精神分裂症患者的子女数相 对多些， >8% 的患者的子女数 为 0 ，大多数（ 45% ）患者有 1 个孩子， 3% 有 2 个孩子， 15% 有 2 个孩子以上。 对照组中，有 2 个以上子女者 较多（女性 22 名，男性 30 名），没有子女的男性患者 仅 4 名、女性 5 名，有 1 个子女的女性有 46 名、男性有 37 名。
  结论 ： 无 论是男性还是女性 ， 该医院住院的精神分裂症患者的独身率和生育率均低于对照组。
  
  Objectives: Rates of unmaried status in male schiz.pt`s is found to be high in earlier studies. no. of children produced in female schiz. pat`s also tends to be low (Eaton1985, Kallman1938) due to long time institutional stay,use of newer anti- pshychotics, which may elevate pl. prolactin level,lack of emotional warmth or a poor quality of sexual relationship.
  Methods: 144 schizoprenic patients of both sexes attending calcutta pavlov hospital o.p.d during 2004-05 were enlisted.they were mached against another 144 patients suffering from affective disorders.72 male & 72 female all between 30-45 years of age were registered in both the 2 groups. Their mariatl status were first analysed.thereafter their children no. were noted in the married groups.
  Results: Among144 pt. attended o.p.d with a diagnosis of scizoprenia(schiz) as per DSM-4TR criteria, there 53 married in the gr. of 72 males unmarried no. being 15.in the 72 females of schiz. gr., 60 were married, unmarried were only 2 and separated or divorced were 8, & living separetely without judicial sanction is 2. In male schiz. gr. separated or divorced were 4 with a history of no 2nd maraige in them.In other gr., mostly suffering from affective disorders, 67 married, 3 separeted, 2 unmarried in male gr. 70 married, 1 widow, and 1 unmarried were there in female non-schiz. gr.
  Objervations: In male schiz. gr. unmarried rate is very high(>20%). in female schiz. setting it is extremely low(>3%).Separation and divorce rate is very high in female schiz. gr.(15%). Separation, divorce and living apart is low in male(>8%).
  In non schiz. gr.marraige rate is very high in male (>92%), and female(95%). Separation and divorce rates are also very low in both male(4%) and female (0). Reprudctive rate is less in male who acconts for 0 issue in>15% cases.single child is in majority(55%) and20% with 2 issues and 12% only produce > 2 issues.rate of reprd. is not so low in female where > 8% have 0, majority (45%) one issue and 3% 2 issues, and 15% > 2 issues. In other control gr.in male and female more than 2 issues is high (22 & 30) 0 issue was noted in 4 & 5 cases only. 1 child mother no. 46 in female &37 in male.
  Conclusions: Singularity and low reproductive rates were observed in both sexes of schiz.pt. attendig this hosp. in compare to others
  
• 147
  Double-Blind Comparison of Ziprasidone and Risperidone in the Treatment of Chinese Patients with Acute Exacerbation of Schizophrenia
  Hongyan Zhang 1 , Liang Shu 1 , Huafang Li 2 , Niufan Gu 2 , Gang Wang 3 , Yongzhen Weng 3 , Shiping Xie 4 , Xinbao Zhang 4 , Ting Li 5 , Cui Ma 5 , Wei Yu 6 , Manjula Schou 7 , Anil Jina 8 , Bruce Parson 8 , Andrea Malcolm 7
  1 Peking University, Institute of Mental Health, Beijing, Chinese Mainland, 2 Shanghai Mental Health Center, Shanghai, Chinese Mainland, 3 Capital Medical University affiliated Anding Hospital, Beijing, Chinese Mainland, 4 Nanjing Brain Hospital, Nanjing, Chinese Mainland, 5 Guangzhou Brain Hospital, Guangzhou, Chinese Mainland, 6 Pfizer China, Beijing, Chinese Mainland, 7 Pfizer Asian Biometric Center, Sydney, Australia, 8 Pfizer Inc., New York, United States
  
  Objectives: To evaluate efficacy, safety, and tolerability of ziprasidone versus risperidone in Chinese patients with an acute exacerbation of schizophrenia.
  Methods: Inpatients met Chinese Classification of Mental Disorders (CCMD-3) criteria for schizophrenia and with PANSS total score >60 recruited, and randomly assigned to 6 weeks of double-blind treatment with flexible doses of ziprasidone 40 to 80 mg bid or risperidone 1 to 3 mg bid. It was a non-inferiority study. The non-inferiority was demonstrated if upper limit of 2-sided 95% CI for difference between two groups in PANSS total score improvement in Per Protocol population was smaller than pre-specified 10 units.
  Results: ITT population consisted of 118 patients treated with ziprasidone (baseline PANSS total score, 83.8±13.1) and 121 patients treated with risperidone (baseline PANSS total score, 84.9 ±13.4). Mean daily dose of ziprasidone was 118.5±18.1 mg; and that of risperidone was 3.8 ±0.8 mg. At Visit 6, proportion of subjects on highest dose was comparable between groups: 21% ziprasidone; 23% risperidone. Improvement from baseline to week 6 in PANSS total score was equivalent for ziprasidone (-35.6 [95%-CI, -32.6 to -38.6]) and risperidone (-37.1 [95%-CI, -34.4 to -39.9]). Non-inferiority was demonstrated in Per Protocol population with a difference score of 1.5 [95%-CI, -2.5 to 5.5]; and confirmed in ITT population, with a difference score of 4.4 [95%-CI, -0.4 to 9.3]. Significant and comparable levels of baseline-to-week-6 improvement were observed for the two groups on PANSS-positive subscale, PANSS-negative subscale, and BPRSd. Both drugs were well tolerated. However, mean prolactin levels decreased slightly at week 6 for ziprasidone group (change -3.5 ng/mL), but significantly increased for risperidone group (change 61.1 ng/mL): p<0.001. More subjects reported significant weight gain (≥7 kg) in the risperidone group (15%) compared with ziprasidone group (4%). Ziprasidone and risperidone were comparable on change from baseline for movement disorder scales.
  Conclusions: In this Chinese sample, ziprasidone was demonstrated as effective as risperidone with less weight gain and prolactin elevation compared with risperidone. The result is consistent with western studies.
  
  [Baseline Characteristics]
  
   
  
• P148
  精神分裂症后抑郁患者的防御方式及 应对方式研究 - Study of Defense and Coping Style in Post-Schizophrenic Depression Patients
  诏薄 刘 1
  1 江西省吉安市第三人民医院 , 精神科 , 吉安 , Chinese Mainland
  
  目的 ： 探 讨精神分裂症后抑郁患者的心理防御方式及应对方式特点。
  方法 ： 精神分裂症后抑郁 组和对照组均作 DSQ 和 简易应对方式测试。
  结果 ： 分裂症后抑郁患者不成熟防御机制因子得分 显著高于对照组 ， 成熟型及中间型防御机制因子得 分均低于 对照组 ； 积极应对方式得分显著低于对照组 ， 消极应对方式得分显著高于对照组。不成熟防御机制因子分与 CDSS 得分呈 显著正相关；积极应对方式得分与 CDSS 得分呈 显著负相关，消极应对方式得分与 CDSS 得分呈 显著正相关。
  结论： 过多使用不成熟防御机制和消极应对方式可能是导致精神分裂症患者产生抑郁的因素之一。抑郁症状越严重，越多采用不成熟防御机制，少采用积极应对方式；抑郁症状越轻，越多采用成熟防御机制，少采用消极应对方式。
  
  Objective: To investigate the post-schizophrenic depression patients' defense and coping style.
  Methods: Schizophrenia patients of the total scores of brief psychiatric rating scale (BPRS) ≤35 and Calgry Depression Scale for Schizophrenia (CDSS) ≥6 were enrolled in the post-schizophrenic depression groups. The scores of CDSS < 6 were enrolled in the control group. The two groups were tested by the Defense Style Questionnaire (DSQ) and simplified coping style questionnaire.
  Results: The post-schizophrenic depression patients had obviously higher scores of immature than the control group and had lower scores of mature and neurotic mechanism than the control group and had obviously higher scores of projection ， passive-aggressive ， unknown present and repression . The scores of humor were obviously lower than the control group. The scores of positive coping style were obviously lower than the control group. The scores of negative coping style were obviously higher than the control group. The scores of CDSS had obviously positive correlation with the immature mechanism ( r=0.46 ， p<0.01);the scores of CDSS had negative correlation with mature mechanism ( r=0.137) ， the scores of CDSS had positive correlation with neurotic mechanism ( r=0.143) ， the scores of CDSS had obviously negative correlation with positive coping style ( r=0.531 ， p<0.01) ， the scores of CDSS had obviously positive correlation with negative coping style ( r=0.463 ， p<0.01).
  Conclusion: Tend to be immature mechanism and negative coping style is an influencing factor of the post-schizophrenic depression. The more depressive symptom is serious ， the more tend to be immature mechanism ， the seldom tend to be positive coping style; the more depressive symptom is lighter ， the more tend to be mature mechanism ， the seldom tend to be negative coping style. Key words: The post-schizophrenic depression ， defense mechanism ， coping style
   
  
• P149
  维生素 A 代 谢通路中 6 个基因与精神分裂症的 关联分析 - Association Studies between Schizophrenia and Six Genes within the Retinoid Cascade
  Chunling Wan 1 , Baohu Ji 1 , Yongyong Shi 1 , Wei Tang 1 , Lin He 1
  1 Shanghai Jiao Tong University, Bio-X Center, Shanghai, Chinese Mainland
  
  目 标 ： 有 证据表明维生素 A 代 谢异常可能与精神分裂症有关。视黄酸是人体内维生素 A 生物活性形式，人体内 视黄酸水平由视黄酸合成及分解酶类决定，对这些酶编码基因与精神分裂症的关联分析将有助与确定维生素 A 是否在精神分裂症的 发生中起作用。系统地考察编码视黄酸合成与分解酶的多个基因是比单个基因关联分析更符合生物学规律的分析策略，它能更客观、准确地回答维生素 A 代 谢异常是否与精神分裂症 相 关。本研究的目的是：在中国汉族病例 - 对照人群中进行 ALDH1A1 ， ALDH1A2 ， ALDH1A3 ， CYP26A1,CYP26B1 和 CYP26C1 这 6 个基因与精神分裂症的 关联分析，从遗传学角度考察维生素 A 代 谢异常与精神分裂症是否相关。
  素材和方法： 本研究人群包括 229 个精神分裂症患者及 288 个中国 汉族正常对照，用聚合酶链反应 - 限制性片断 长度多态 (PCR—RFLP) 技 术对 ALDH1A1 ， ALDH1A2 ， ALDH1A3 ， CYP26A1,CYP26B1 和 CYP26C1 这 6 个基因中的 19 个 单核苷酸多态（ SNP ）位点 进行基因分型，并做单个位点、单倍型的病例 - 对照关联分析及多基因互作分析。
  结果和结论： 被 检测的 19 个 SNPs 位点的基因型及等位基因分布在疾病和 对照人群中无显著差异。单倍型分析显示：由 ALDH1A2 基因的 rs4646642 ， rs4646555 和 rs4646580 组成的单倍型频率在精神分裂症病人和正常人中显著不同（ p < 0.00001 ）。本研究 结果表明：在中国汉族人群中 ALDH1A2 基因与精神分裂症 关联，可能是该疾病的易感基因。这一结果支持精神分裂症的维生素 A 代 谢异常假说。
  关键词 ： 精神分裂症 ， 关联分析 ， 视黄 酸 ， ALDH1A, CYP26A
  
  Objectives: Vitamin A (retinol), in the biologically active form of retinoic acid (RA), has been proposed a possible involvement in the pathogenesis of schizophrenia. We hypothesized that genetic basis, which compromises the ability of proteins to control the RA level, might be associated with this disease. The cascade genetic association model, using markers in genes of synthesis and degradation enzymes within the retinoid cascade, would better fit the biological character of the retinoid hypothesis than the single gene strategy. The present study aims to evaluate whether retinoid is involved in the pathophysiology of schizophrenia.
  Methods: In the present study we chose to investigate 6 genes involved in the synthesis or degradation of RA, ALDH1A1, ALDH1A2, ALDH1A3, CYP26A1, CYP26B1 and CYP26C1, for their roles in the development of schizophrenia. We genotyped 19 single nucleotide polymorphisms (SNPs) in the regulatory and coding regions of these six genes using PCR-RFLP technology in the 618 Chinese Han subjects. Case-control analyses were performed to detect association of these six genes with schizophrenia.
  Results: Association analyses using both allelic and genotypic single-locus tests revealed no significant association between the risk for each of investigated gene and schizophrenia. However, analyses of multiple-locus haplotypes indicated that the overall frequency of ALDH1A2 haplotype showed significant difference between patients and control subjects (p < 0.00001). We also employed multifactor dimensionality reduction method to detect multilocus effects.
  Conclusions: Ours is the first report on multiple candidate genes involved in retinoid cascade in schizophrenics. In addition, our results suggest a positive association between ALDH1A2 and schizophrenics in the Chinese population and support the retinoid hypothesis of schizophrenia.
  Key words: schizophrenia, genetic association, retinoic acid, ALDH1A, CYP26A
   
  
• P150
  應用肌肉放鬆練習並配合生理迴饋儀器來改善 精神病患焦慮之護理過程 - Combining the Muscle Relaxation Method with Biofeedback Equipment Manipulation for Nursing Psychiatric Patient's Anxiety
  秀 苔 鮑 1
  1 財團法人奇美醫院 , 護理部精神科 , 台南市 , Taiwan , Province of China
  
  本文為協助一位慢性精神分裂症的病患改善焦慮情緒之護理過程。護理期間為 2006 年 10 月 24 日至 2006 年 12 月 4 日。個案對於生活瑣事易 產生，焦慮情緒殘餘精神症狀，導致人際關係緊張、生活適應不良、生產能力下降，甚至 於案母也出現自殺的想法。筆者應用肌肉放鬆練習配合生理迴饋儀器，並傳遞真誠、接納、關懷及恆久耐心 說明、示範、演練、修正，約經過一個多月個案人際間的敏感、焦慮反應精神症狀傾、哭泣、請假、 PRN 用藥、家屬抱怨次數、案母看精神科次數明顯改善，生活滿意度提升。使原本只想遠離或放棄個案的母親，重新燃起對女兒的愛，雖然個案有時仍會有焦慮反應，但大部分的時間個案都展現微笑的臉龐，已得到許多人的肯定。結果顯示精神科護理人員，可藉由肌肉放鬆練習配合生理迴饋儀器，改善個案焦慮的情緒，並可改善個案的生活品質，進一 步亦影響家屬能重新 調整與配合治療。
  
  The study herein was the nursing of the chronic schizophrenia patient to improve the anxiety from October 24 to December 4, 2007. The trivia-caused residual symptom resulted in the strained interpersonal relationship, poor adaptability, and reduced productivity, and even her mother suicide attempt.
  Asides from the muscle relaxation method and biofeedback equipment manipulation here, the sincerity, acceptance, care, patience, demonstration, rehearsal, and mind adjustment were offered. The life satisfaction was increased after more than one month in view of the significant difference of the patient's interpersonal relationship sensitivity, anxiety reaction, crying, taking off, PRN medication, family complaint frequency, and mother psychiatric visits.
   
  
• P151
  氯氮平治疗分裂症对超敏 c 反 应蛋白及糖脂代谢的影响 - The Influence on Hypersensitivity CRP (C Reaction Protein) and Glycolipid Metabolism Treating Schizophrenia with Clozapine
  昕 高 1
  1 天津市安定医院 , 天津 , Chinese Mainland
  
  目的 : 探 讨氯氮平对精神分裂症患者的超敏 c 反 应蛋白、空腹血糖、甘油三脂、胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白 A1 、 载脂蛋白 B 的影响及其之 间的相关性。
  方法 : 对 30 例服用 氯氮平治疗的分裂症患者分别于治疗前、治疗第 4 、 8 、 12 周 检测超敏 c 反 应蛋白、空腹血糖、甘油三脂、胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白 A1 、 载脂蛋白 B ， 将 30 例健康 职工作为对照组也检测上述指标。研究不同治疗期各指标的变化程度以及之间的相关性。 结果 治 疗前研究组和对照组各值差异无显著性。不同治疗期超敏 c 反 应蛋白、空腹血糖、甘油三脂、胆固醇、低密度脂蛋白、载脂蛋白 B 呈升高 趋势，其中超敏 c 反 应蛋白在治疗第 4 、 8 、 12 周，空腹血糖、甘油三脂、胆固醇、低密度脂蛋白、 载脂蛋白 B 在治 疗第 12 周与治 疗前比较差异具有显著性；高密度脂蛋白、载脂蛋白 A1 在不同治 疗期呈下降趋势，治疗第 12 周与治 疗前比较差异具有显著性。超敏 c 反 应蛋白与空腹血糖、甘油三脂、胆固醇以及氯氮平剂量呈正相关。结论 氯氮平对超敏 c 反 应蛋白、糖脂代谢均会产生影响，氯氮平导致代谢综合征可能与超敏 c 反 应蛋白有关。
  关键词 : 精神分裂症 ； 氯氮平 ； c 反 应蛋白 ； 血糖 ； 血脂
   
  
• P152
  The Impact of Clozapine on hs-CRP, Metabolism of Glucose and Lipids in the Patients of Schizophrenia
  Xin Gao 1
  1 Anding Hospital in Tianjin, Tianjin, Chinese Mainland
  
  Objective: To explore the impact of Clozapine on the aspects of hs-CRP (High-sensitivity C-reactive protein), metabolism of glucose and lipids in the patients of schizophrenia.
  Methods: Thirty patients treated with clozapine for 12 weeks were selected as the study group, and the control group was formed by 30 healthy stuffs in the hospital. The hs-CRP, blood glucose, triglylipoprotein cholesterol, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apoprotein A1 and cholesterol B of the patients were determined at baseline and on weeks 4,8,12. Thirty normal controls were determined them in the same way.
  Results: Before the treatment the hs-CRP, metabolism of glucose and lipids were not significantly higher in schizophrenic patients than the normal controls. The hs-CRP was significantly higher in schizophrenic patients with clozapine on weeks 4,8,12 than at baseline. The blood glucose, triglylipoprotein cholesterol, total cholesterol, low density lipoprotein cholesterol, apoprotein and cholesterol B were significantly higher in schizophrenic patients with clozapine on weeks 12 than at baseline. The high density lipoprotein cholesterol and apoprotein A1 were significantly lower in schizophrenic patients with clozapine on weeks 12 than at baseline. Correlation and regression analysis have shown that the hs-CRP level after treatment were positively correlated with blood glucose, triglylipoprotein cholesterol, total cholesterol and dosage of clozapine.
  Conclusions: Clozapine possibly influences the hs-CRP, metabolism of glucose and lipids in schizophrenia. There is significant relationship between the hs-CRP and clozapine.
  Keywords: Schizophrenia ； Clozapine ； hs-CRP ； Blood glucose ； Blood lipid
  
• 153
  Research on Glycometabolism of First Degree Relatives of Schizophrenia
  立文 谭 1
  1 中南大学湘雅二医院精神 卫生研究所 , 长沙 , Chinese Mainland
  
  Objective:: To research the glycometabolism of the first-degree relatives of schizophrenia.
  Methods: The height, body weight, fasting blood glucose (FBS), insulin and C-peptide of 85 first-degree relatives of schizophrenia and 99 controls were measured, the body mass index (BMI) and insulin resistance index (IRI) were calculated.
  Results: The relatives showed higher morbidities of diabetes and impaired glucose tolerance (IGT) than those of controls （ 5.9%/15.3% VS 4.0%/13.1% ） , although which were not significant （ P1=0.564, P2=0.675 ） . So did the levels of fasting blood glucose, insulin and IRI of the relatives than those of controls (P1=0.298, P2=0.463, P3=0.968).
  Conclusion: No significant difference in blood sugar metabolism was observed between the first-degree relatives of schizophrenia and the controls.
   
  
• P154
  门诊精神分裂症病人生活质量及其相关因素的研究 - Quality of Life of Outpatients with Schizophrenia and its Correlation with Related Factors
  兰 尚 1 , 仕友 孙 1
  1 北京回 龙观医院 , 北京 , Chinese Mainland
  
  目的 ： 探 讨门诊精神分裂症病人的生活质量及其相关因素分析。
  方法 ： 纳入 100 例 门诊精神分裂症患者 ， 符合 ICD － 10 诊断标准 ， 收集一般资料 ， 采用世界卫生组织生活质量量表 （ 简版 ） 评定生活质量、阳性、阴性症状量表 （ PANSS ） 评定精神症状、总体功能 量表 （ GAF ） 评价社会功能。
  结果 ： 生活 质量与阴性症状显著性负相关 ， 而与阳性症状无显著性相关 ， 有工作的生活质量显著高于无工作的倾向 ， 病人自评的药物副反应与生活质量无显著性相关 ， 第二代抗精神病药与第一代的生活质量差异无显著性 ， 男性病人的生活质量显著高于女性 ， 而婚姻状况与生活质量关系不显著。
  结论 ： 改善 阴性症状、参加工作可能显著地提高病人的生活质量 ， 而第二代抗精神病药并不比第一代显著改善生活质量。
  
  Objective: To investigate quality of life of outpatients with schizophrenia and its correlation with related factors.
  Methods: 100 schizophrenic cases met the criteria of ICD-10 were recruited and evaluated by Positive and Negative Syndromes Scale (PANSS), General Assessment Functioning (GAF), and WHO Quality of Life (brief version).
  Results: There were significant correlation between quality of life (QOL) and negative syndromes, rather than positive syndromes. QOL of patients with employment trend to be higher than that of unemployment. There was no significant relation between QOL of the patients with side-effect and without side-effects rated by themselves. There was no significant relation between QOL of the second-generation antipsychotics and first-generation antipsychotics. QOL of male patents was higher than that of female. There was no significant relation between QOL and marital states of the patients.
  Conclusion: QOL of patients could be improved by ameliorating negative syndromes and employment.
  Keywords: schizophrenia, quality of life
   
  
• P155
  精神分裂症、 单相抑郁症和躁狂症认知功能的比较 - Differential Cognitive Deficits in Patients with Schizophrenia, Major Depression and Mania: An Exploratory Study
  萱 欧阳 1 , 哲宁 刘 1 , A10
  1 中南大学湘雅二医院精神 卫生研究所 , 长沙 , Chinese Mainland
  
  目的 ： 探 讨精神分裂症、单相抑郁症和躁狂症三种疾病的认知功能特点 ， 期望为这三种疾病的鉴别诊断提供参考依据。 方法： 采用威斯康星卡片分 类测验（ WCST ），倒行掩蔽 测验（ BMT ）以及 连续操作测验（ CPT ） 对 66 例精神分裂症患者、 44 例 单相抑郁症患者、 28 例躁狂症患者、以及 51 例正常人 进行测评，评估工作记忆／执行功能、注意以及早期的视觉信息加工。
  结果： （ 1 ）在 WCST 中，精神分裂症、 单相抑郁症以及躁狂症患者总的测验次数显著高于正常人 (p<0.05) ，且精神分裂症患者 总的测验次数显著高于单相抑郁症患者 (p<0.05) 。精神分裂症患者的正确反 应数显著低于单相抑郁症患者和正常人 (p<0.05) 。精神分裂症、 单相抑郁症、躁狂症患者的持续错误数、随机错误数均显著高于正常人 (p<0.05) ，且精神分裂症患者的非持 续错误数显著高于单相抑郁症患者 (p<0.05) 。 仅精神分裂症患者的完成分类数显著低于正常人 (p<0.05) ，并且 显著低于单相抑郁症、躁狂症患者 (p<0.05) 。（ 2 ）在 BMT 中，精神分裂症患者在无掩蔽干 扰时的认对数显著低于躁狂症患者和正常人 (p<0.05) 。精神分裂症、 单相抑郁症患者在掩蔽间隔为 30ms 时的认对数显著低于正常人 (p<0.05) ，而躁狂症患者与正常人无 显著差异 (p>0.05) 。精神分裂症患者在掩蔽 间隔为 50ms 时的认对数 以及三 种情况下的总认对数均显著低于单相抑郁症、躁狂症患者和正常人 (p<0.05) ，而躁狂症患者与正常人之 间无显著差异 (p>0.05) 。 3 、在 CPT 中，精神分裂症患者的 认对数显著低于单相抑郁症、躁狂症患者和正常人 (p<0.05) ，而 单相抑郁症、躁狂症患者和正常人之间无显著差异 (p>0.05) 。

  结论： 精神分裂症患者与 单相抑郁症、躁狂症患者相比，不仅存在更为严重的工作记忆／执行功能的缺陷，而且还存在早期视觉信息加工和注意力的异常。提示精神分裂症与其他两种疾病相比 ， 认知功能损害更加严重和广泛。
  
  Objective: To explore if there is any differential cognitive deficits in patients with schizophrenia, major depression, and mania.
  Method: 66 patients with schizophrenia, 44 patients with major depression, 28 patients with mania, and 51 healthy controls were recruited for this study. All of them were administered with neurocognitive tests capturing sustained attention (Continuous Performance Test, CPT), executive function (Wisconsin Cart Sorting Test, WCST), and early visual information processing (Backward Masking Test, BMT).
  Results: (1) All of the patients performed significantly worse than the controls on all the domains of the WCST (P<0.05). In particular, the patients with schizophrenia performed significantly worse than the those with major depression and mania on category scores (P<0.05) and the number of sorting (P<0.05), respectively. (2) Patients with schizophrenia also performed significantly worse than those with mania and the controls when backward masking was absent (P<0.05). Moreover, both patients with schizophrenia and major depression performed significantly worse than the controls when the masking interval was 30 milliseconds (P<0.05). However, no significant difference was found between the patients with mania and the controls. (3) Patients with schizophrenia performed significantly worse than those with major depression and mania, and the controls in CPT (P<0.05). However, there was no significant difference found between patients with major depression and mania, and the controls.
  Conclusions: The present findings suggest that differential cognitive deficits were shown among schizophrenia, major depression, and mania. In particular, patients with schizophrenia demonstrated significant deficits in all aspects of sustained attention, executive function, and backward masking.
   
  

• P156
  阴性、阳性精神分裂症 . P3 波异常与 临床症状关系的追踪对比研究 - A Tracing Study of Correlation between Event Relate Potentials P3 and Clinical Symptoms of Negative and Positive Schizophrenic Patients
  红 杨 1 , 段慧君 郭 凤莲 黄 润虎 张克让
  1 山西医科大学第一医院 , 太原 , Chinese Mainland
  
  目的 ： 通 过分析未用抗精神病药物和治疗 1 月、 3 月、 6 月后的 阴 性、阳性精神分裂症患者 FZ 、 CZ 、 PZ 位点事件相 关电位 P3 波与 临床症状的关系 ， 探讨阴性、阳性精神分裂症及其事件相关电位 P3 波异常的异 质性。
  方法 ： 收集阳性精神分裂症患者 35 例、 阴性精神分裂症 36 例。 记录所有被试 FZ 、 CZ 、 PZ 位点事件相 关电位 P300 靶刺激 P3 波幅。两 组患者用维思通（ 2-6mg/ 日）治 疗 1 月、 3 月、 6 月后 复查以上 P300 指 标。采用 SPSS 统计软件包，用独立样本 t 检验、 Spearman 相 关分析进行数据分析。
  结果： 1. 阴性与阳性精神分裂症组相比：治疗前 FZ 点 P3 波幅有降低 趋势（ P=0.05 ）。 2. 阴性患者组内治疗 1 月后， CZ 点 P3 潜伏期与思 维障碍分呈正相关；治疗 3 月后， FZ 点 P3 波幅与阳性症状分呈 负相关；治疗 6 月后， FZ 点靶刺激 P3 潜伏期与阳性症状分呈正相 关。 3. 阳性患者 组内治疗前 FZ 点靶刺激 P3 潜伏期与偏 执分呈正相关；治疗 3 月后， CZ 点 P3 波幅与偏 执分、复合分呈负相关。 结论： 1. 阴性、阳性精神分裂症患者事件相关电位 P300 中 P3 波异常及其与 临床症状的相关性不同，疾病不同阶段两组患者 P3 波 变化趋势也不同。
  2. 阴性精神分裂症患者急性期和治疗早期以 CZ 、 PZ 点 P3 波异常 为主，并与思维障碍、阴性症状、抑郁症状相关；以 FZ 点 P3 波异常 为主，并与阳性症状相关。提示阴性精神分裂症患者急性期和治疗早期以中央区、顶区异常占主导地位，治疗后期的额区异常仍然显著。
  3. 阳性精神分裂症患者 P3 波异常先后在 FZ 点和 CZ 点与偏 执症状相关，治疗后期这种相关性渐减弱、消失。提示阳性精神分裂症患者急性期额区异常占主导地位 ， 治疗后期的中央区异常仍然显著。
  
  Object ： Through tracing and contrasting correlation between event relate potentials P3 and clinical symptoms of Negative and Positive Schizophrenic Patients who were we tried to investigate the heterology of P3 in negative and positive schizophrenia.
  Method ： We adopt 35 positive schizophrenia and 36 negative schizophrenia consistent with DSM-IV. The Positive and Negative Syndrome Scale and the Event-related potential P300 of Fz 、 Cz 、 Pz were recorded recording P3 latency and. Recheck these indexes
  Result ： 1. In comparison with positive schizophrenia, negative schizophrenia had lower amplitude of P3 before treating. 2. In the group of negative schizophrenia there were significant positive correlation between P3 latency and thinking disturbance , significant negative correlation between P3 amplitude and total score after being treated 1 month. There were significant negative correlation between P3 amplitude and positive symptoms after being treated 3 months. 3. In the group of positive schizophrenia there were significant negative correlation between P3 amplitude and complex score after being treated 3 month.
  Conclusion ： 1. The correlations between the abnormality of P3 and clinical symptom between two groups were different .
  2. The abnormality in negative schizophrenia during early treatment period was mainly in parietal region. The abnormality in rontal region remains significant during late treatment period.
  3. The abnormality of positive schizophrenia in acute stage was mainly in frontal region. The abnormality in central region remains significant after being treated.
   
  

• P157
  The GABAA Receptor Gamma3 Subunit Gene (GABRG3) Possibly Associated with Auditory Hallucination of Schizophrenia
  Kerang Zhang 1 , Ning Sun 1 , Qi Xu 1 , Hong Yang 1 , Yan Ren 1 , Liang Niu 1 , Yan Shen 1
  1 First Hospital of Shanxi Medical University, Psychiatry Department, Taiyuan, Chinese Mainland
  
  Objective: Schizophrenia (SCZ) is a complex mental disease that affects approximately 1% of the population. Gamma-aminobutyric acid is one of the most important inhibitory neurotransmitters in the mammalian central nervous system. Many studies found gamma-aminobutyric acid system disfunction in schizophrenia patients. Schizophrenia is a highly clinical and genetic heterogeneous disorder. Different clinical subtypes may have different genetic bases. More homogeneous clinical samples may increase the power of association studies. The present study was to investigate the correlation between GABAA receptor genes and major phenotypes in paranoid schizophrenia.
  Methods: The sample consisted of 80 unrelated patients with paranoid schizophrenia (36 males and 44 females; mean age, 24.9 ± 5.8 years, range 16-37 years) and 108 matched normal controls (56 males and 52 females, mean age 25.8 ± 5.8 years, range 18-40 years). All patients and Control volunteers were recruited from Beijing , north China , who were unrelated Han Chinese and gave written informed consent. All patients were diagnosed as having a schizophrenic illness using ICD-10 criteria, and interviewed by the consensus of at least two experienced psychiatrists and diagnosed according to the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Detailed information of a history of the illness, hospitalization and medication were recorded. 52 reported single nucleotide polymorphisms (SNPs) in the coding or untranslated regions of the GABAA receptor genes were genotyped by polymerase chain reaction (PCR) and direct sequencing of PCR products. Hardy–Weinberg equilibrium for SNPs were evaluated using the χ 2 test. The major phenotypes were analyzed as quantitative traits using the UNPHASED program.
  Results: The quantitative trait test revealed a genetic association between SNPs rs140679, rs2303879 and auditory hallucination (P=0.0039 for rs140679 and P=0.0029 for 2303879) in female patients, while the others did not show such an association. The permutation test showed a strong association (global P=0.045 for 10000 permutations).

  Conclusion: The present results may suggest that the GABRG3 gene is likely to contribute to the development of auditory hallucination of paranoid schizophrenia.
   
  
• P158
  首次 发作未服药精神分裂症患者的异常事件相关 gamma 共振 - Abnormal Event-related Gamma Oscillations in Drug-naive and First Episode Schizophrenia Patients
  继军 王 1 , 明 岛 张 1 , 斌 谢 1 , 泽萍 肖 1 , 精神分裂症与神 经认知功能
  1 上海交通大学医学院附属精神 卫生中心 , 上海市 , Chinese Mainland
  
  目的 : 在首次 发作未服药精神分裂症患者中验证 gamma 共振异常 ， 同 时探讨精神分裂症患者中 gamma 共振与其 P300 之 间的关系。
  方法 : 研究 对象 ： 首次发作未服药精神分裂症患者 34 例 ； 正常 对照 30 例。所有被 试签注知情同意书。被试进行靶音和非靶音识别作业时，同步记录脑电信号。应用小波分析方法提取事件相关 gamma 共振波。 结果。刺激后 150 毫秒至 200 毫秒，患者 额中央区（ Fz ）的 gamma 共振 显著减弱（ F=4.2, P=0.04 ）。患者 额区和顶区的事件相关电位 P300 波幅均明 显降低。 P300 潜伏期在两 组之间没有明显差异。对于两组被试， gamma 共振与 P300 指 标均缺乏显著相关性。
  结论 : 精神分裂症患者的前 额区事件相关 gamma 共振，在排除 药物和病程影响后，仍具有显著异常，可能具有病因学意义。它的出现时间窗口，早于 P300 的出 现时间窗口，可能启动了患者的异常 P300 。但是， 这方面的关系还需要进一步研究。
  
  Aim: To confirm the abnormal event-related gamma oscillations in drug-naive and first episode patients, and to examine the relationship between gamma oscillations and P300 component of ERPs.
  Methods: Subjects were 34 drug-naive and first episode schizophrenia patients and 30 healthy controls. Informed consent was obtained from individual subject. When the subject performed the cognitive task of target ／ nontarget tone discrimination, the EEG signals were recorded. EEG signals of the gamma oscillations were extracted using Wavelet analysis.
  Results: During 150-200 ms post-stimulus, patients showed a significantly reduced event-related gamma oscillations at Fz, as compared to the control group （ F=4.2, P=0.04 ） 。 P300 amplitude was reduced in patients. P300 latency showed no difference. No significant correlation was detected between the gamma oscillations and P300 measurements.
  Conclusion: Abnormal event-related gamma oscillations at Fz was detected for drug-naive and first episode schizophrenia patients, possibly suggesting it as a primary effect of schizophrenia. It occurred earlier than the P300 component, might initiating the abnormal P300 in schizophrenia. However, this relationship still needs further study.
  
• 159
  運用社交互動訓練於精神分裂病患之護理經驗 - A Nursing Experience of Applying Social Skill Training to a Patient with Schizophrenia
  瑜 安 李 1
  1 財團法人奇美醫院 , 護理部精神科 , 台南市 , Taiwan , Province of China
  
  本文探討一位精神分裂症病患因疾病關係導致功能退化與外界無法建立良好的人際關係 ， 藉由社交訓練改善其社交互動之護理經驗。護理期間為 95 年 8 月 29 日至 95 年 10 月 7 日，筆者依五大層面的整體性護理評估作為指引，發現個案有：思考過程變異及社交互動障礙的護理問題，照護期間筆者首先與個案建立良好的護病關係，當個案正向症 狀穩定後，鼓勵個案學習「社交互動技巧」及搭配「社交技巧缺失紀錄表」使用，訓練過程主要依照：講解、示範、角色扮演、回饋與增 強及作業練習的原則循序漸進。結果發現，個案除社交能力有進 步外，也逐步改善因疾病引發的不當人際關係、退化行 為、對自我有正向評價。此護理經驗可得知，護理人員可發揮其獨立功能，協助精神分裂症病患適切的社交互動技巧訓練，以利出院後生活適應。
  
  The purpose of this article is to discuss about the application of social skill training to a schizophrenic patient with declining function and impoverished interpersonal relationships to promote social interactions. Comprehensive assessments were made via “5 phases of measures” and summed up patient's problems to be formal thought disorder and impaired social interactions. The training program was conducted step-by-step during the period from 2006-08-29 to 2006-10-07. Initially the author aimed to establish rapport with the patient, when patient was reasonably well stabilized on their medications, then encouraged patient to learn “social skills” according to “social deficits record”.Techniques such as instructions, coaching, role-playing, demonstrations, practice and homework assignments belies the challenges of the training process. As a result, improvements in social functioning, modifications of inappropriate interpersonal relationships and regressive behaviors, and establishment of positive self-view were observed. Through this experience we learned that nursing staff was capable of working independently to provide social skill training to schizophrenic patient to prepare for real life challenge.
   
  
• P160
  妄想型精神分裂病患長期垂頭站立行為之護理 - Nursing of Paranoid Schizophrenia Patient Used to Standing and Drooping
  寧 宛 馬 1
  1 財團法人奇美醫院 , 護理部精神科 , 台南市 , Taiwan , Province of China
  
  本文協助一位 48 歲妄想型精神分裂症個案 ， 處理其因妄想導致之長期垂頭、站立行 為的護理經驗。護理期間自 91 年 2 月 1 日至 91 年 5 月 22 日。根據生理、情緒、智能、社會、靈性五大層面整體評估，確認個案主要核心護理問題為思考過程變異及家庭因應能力失調。筆者藉由生理照護層面介入，與個案建立治療性關係，進一 步協助個案持續復健活動之進行，使個案因症狀干擾，導致頸部關節曲度呈 30 度無法伸展的情形回復正常。治療期間個案堅信「為主作工」的信念而持久站立一天 12 小時，筆者秉持著行善原則借力使力，運用現實情境及替代行動，轉移個案注意力，鬆動個案固化想法，使個案學習以「助人行為」，替代「為主做工」，減少個案持久站立之情形。 歷經藥物治療及 17 次電氣痙攣療法，個案仍堅信為主作工之信念，但已為垂頸及持久站立的行為，明顯改善個案之生活品質。個案進而可參與治療活動，同時也讓家屬得以重新認識疾病，學習如何與個案相處。
  
  The case here from February 1 to May 22, 2005 was to care for the 48-year-old paranoid schizophrenia patient used to standing and drooping. The nursing problems were asserted after the physical, emotional, intelligent, social, and spiritual assessment: the thinking process variation and family coping ability dysfunction.The nurse-patient therapeutic relationship was built after the nursing intervention before the patient did rehabilitation under assistance, and the symptoms-caused inflexible neck joint angle (30 degrees) became normal.During nursing, the patient believed that he was standing 12 hours a day for doing the Lord's work. The author softened the patient's hardened heart via helping the patient with the right way: The time spent on standing and drooping for working for the Lord was reduced by that on helping people.Despite the medication and electroconvulsive therapy provided, the patient's belief in working for the Lord by standing and drooping for a long time no longer existed, and the life quality was greatly improved. The patient attended the therapeutic activities, and the family learned to cope with the patient.
   
  
• P161
  利培 酮合并脑活素治疗以阴性症状为主的精神分裂症的双盲随机对照研究 - Therapeutic Effects of Cerebrolysin Added on Risperidone in Patients with Negative Symptom Dominated Schizophrenia
  Shifu Xiao 1 , 肖世富 苑成梅 李冠 军 李霞 薛海波 黄 红芳 郭彩弟 曹新妹 张明园
  1 Shanghai Mental Health Center,Shanghai Jiaotong University School of Medicine, Geriatric Psychiatry, Shanghai, Chinese Mainland
  
  目的 : 探索利培 酮合并脑活素治疗 精神分裂症的 阴性症状和认知症状的疗效和安全性。方法 采用随机、双盲、安慰 剂对照的平行设计，分为研究组与对照组两组，研究组用脑活素合并利培酮，对照组用利培酮和安慰剂治疗。在治疗前、治疗后 2 周、 4 周、 8 周分 别对患者进行疗效评定。
  结果 : 109 名符合 DSM- Ⅳ 诊断标准的慢性精神分裂症患者入组， 101 名完成研究；安慰 剂组 49 例，男 34 ，女 15 ； 脑活素组 52 例，男 41 ，女 11 。两 组治疗前后， PANSS 总分及阳性、阴性因子分无显著性差异。治疗后 2 周、 4 周、 8 周，两 组的语言智商、作业智商及总智商减分有显著差异（ p<0.05 或 0.01 ），利培 酮合并脑活素组的疗效优于对照组。两组的记忆商减分无显著性差异（ p>0.05 ）。治 疗结束时，两组间在疾病严重程度和 CGI 总体印象改变方面均无显著性差异（ p>0.05 ）。治 疗期间未观察到与治疗药物有关的严重不良事件。结论 按本研究方案， 脑活素对阴性症状为主的精神分裂症的阴性症状无明显治疗效果。脑活素对阴性症状为主的精神分裂症的认知功能有显著改善，可显著提高患者的语言智商和总智商得分，但对记忆商无显著性改善。脑活素治疗阴性症状为主的精神分裂症患者安全。
  关键词 : 精神分裂症 脑活素 认知功能 阴性症状
  本 课题受美国斯坦利医学研究基金资助（ 02I-005 ）
  
  Objective: Cerebrolysin is a nootropic drug directly affecting cerebral neurons due to its unique neurotrophic activities. This study evaluated the efficacy and safety of cerebrolysin added on risperidone in patients with negative symptom dominated schizophrenia.
  Methods: The trial was of a double-blind, placebo-control, parallel-group design. The effective results were assessed with measurements including the Positive and Negative Symptoms Scale (PANSS), Memory Scale (WMS), Wechsler Adult Intelligent Scale (WAIS) and Clinical Global Impression (CGI).
  Results: 109 patients who met the DSM-IV diagnostic criteria for schizophrenia were randomized to treatment with either 30 ml cerebrolysin or placebo intravenous infusion once daily from Monday to Friday for four weeks, (cerebrolysin group 55cases and placebo 54 cases). Patients treated with cerebrolysin showed statistically significant improvement in the total IQ and language IQ scores (increased 3.72 and 7.47 on everage) of WAIS test at the end point of treatment compared with patients treated with placebo (p<0.01).There were no significant differences in the measurements of PANSS, WMS and CGI during treatment between the two groups, and there was no significant difference in the rating of treatment adverse events.
  Conclusion: Cerebrolysin added on risperidone can improve cognitive deficit of patients with negative symptom dominated schizophrenia. There are no significant side effects observed during cerebrolysin treatment. Key words: Schizophrenia Cerebrolysin Risperidone Effect
  This clinical trial is supported by grant of Stanley Medical Research Institute (02I-005)
   
  
• P162
  Transmission Disequilibrium of NOTCH4 and GRIK2 in Han Chinese Mixed Pedigrees of Schizophrenia and Bipolar Disorder
  Zuowei Wang 1
  1 Hongkou Mental Health Center of Shanghai, Shanghai, Chinese Mainland
  
  Increasing evidence suggests an overlap in genetic susceptibility across the traditional classification systems that dichotomised psychotic disorders into schizophrenia or bipolar disorder. Recently several studies showed that NOTCH4 and GRIK2 may be susceptibility genes to schizophrenia. Until now there was no report about positive association between two genes and bipolar disorder. This study is to explore whether schizophrenia and bipolar disorder share genetic susceptibility in loci of NOTCH4 and GRIK2 in Han Chinese population. We collected 65 mixed pedigrees of schizophrenia and bipolar disorder in Han Chinese population, and then applied transmission disequilibrium test (TDT) to investigate the relationship between the two genes and schizophrenia or bipolar disorder. The results showed -25T/C polymorphism of NOTCH4 was associated significantly with bipolar disorder (especially for early-onset patients) and –1725G/-25T haplotype with schizophrenia. SNP rs6922753 of GRIK2 was associated significantly with schizophrenia and bipolar disorder in early-onset patients, SNP rs2227283 and haplotypes TG, CA were significantly associated with both schizophrenia and bipolar disorder. Our results suggest that schizophrenia and bipolar disorder may share genetic susceptibility in mixed pedigrees of Han Chinese population, and NOTCH4, GRIK2 or neighboring gene may be one of common susceptibility genes for those psychoses. It prompted us to speculate about a hierarchical model of preformed dimensional patterns of psychopathology.
   
  
• P163
  慢性精神分裂症院内 职业康复十八年随访观察 - A 18y' Long-term Following-up Observation of Employment Rehabilitation within Hospital for Chronic Patients with Schizophrenia
  盛 嘉 玲 1 , 刘 全 春 2 , 张 建 华 3 , 沈 怡 1 , 戴 晶 璟 4
  1 上海市民政第一精神病院 , 三病区 , 上海 , Chinese Mainland, 2 上海市民政第一精神病院 , 院 长室 , 上海 , Chinese Mainland, 3 上海市民政第一精神病院 , 六病区 , 上海 , Chinese Mainland, 4 上海市民政第一精神病院 , 一病区 , 上海 , Chinese Mainland
  
  目的 : 随 访院内职业康复对长期住院的慢性精神分裂症患者康复效果及病情转归 ， 寻找能有效改善无家可归的民政精神病人的院内康复途径。
  方法 : 对 62 例恢 复期精神病患者安排八个职业岗位 ， 并进行十八年的追踪观察 ； 同时与 50 名未参加 职业康复的慢性精神病人进行对照。用 SDSS 、 IPROS 和 BPRS 三 张量表在康复途中进行四次评定。
  结果 : 职业康复组的患者在十八年中其康复疗效及精神残疾改善均显著优于对照组 ， 虽然他们中的一部分人因年迈已退出职业康复组 ， 但他们的生活能力 ， 衰退情况均较对照组好。疾病的复发次数及用药量均明显低于对照组 ； 为医院和个人创造了经济效益。 结论 职业康复对慢性精神分裂症病 人恢 复社会功能 ， 改善残疾程度 ， 稳定病情等方面起到积极的不可替代的作用。
  
  Object: To track the effect and the progression of hospital occupational rehabilitation to definitive hospitalization chronic schizophrenia patients ， seek the hospital rehabilitate ways which can improve homeless civil schizophrenia patient.
  Methods: Sixty two convalescence schizophrenia patients are arranged to attend eight careers, and they are tracing observed for eighteen years; while compared with fifty chronic schizophrenic inpatients who don't participate in the occupational rehabilitation. They are evaluated for forth in the rehabilitation with SDSS Scale, IPROS Scale, and BPRS Scale.
  Result: The patients of occupational rehabilitation group are significantly better than the comparative group in rehabilitation efficacy and improving mental disability. Although some of them withdrawal the rehabilitation group for the elderly, their living ability, recession are better than the compare group. The frequency of recurrence of the disease and treatment was significantly lower than the compare group, and create the economic efficiency for the hospital and themselves.
  Conclusion: Tracing observation plays the positive and the irreplaceable effect to chronic schizophrenia patients in restoring social function, improving the degree of disability and stabilizing illness.
   
  
• P164
  手工 疗法对衰退型精神病人的疗效观察 - Observation in Handcraft Treatment to Declining Psychopath
  怡 沈 1 , 戴 晶 璟 2 , 周 妹 珍 2 , 吴 安 弟 3 , 盛 嘉 玲 4
  1 上海民政第一精神病院 , 三病区 , 上海 , Chinese Mainland, 2 上海市民政第一精神病院 , 一病区 , 上海 , Chinese Mainland, 3 上海市民政第一精神病院 , 五病区 , 上海 , Chinese Mainland, 4 上海市民政第一精神病院 , 三病区 , 上海 , Chinese Mainland
  
  目的 : 探 讨手工疗法对长期住院的慢性衰退型精神病人康复治疗的疗效 ， 以寻找能提高住院精神病人生活质量有效方法。
  方法 : 将一 组衰退型精神病人随机分为手工组和对照组。手工组在用药的基础上给予多样化、趣味化的手工治疗 ， 辅以有奖活动 ， 激励患者的兴趣。于训练前后分别用 SSPI 、 ADLPI 量表 进行评定和临床观察。 结果 手工 组于训练后 ADLPI 总分明显低 于 对照组（ P<0.01 ），其中工具操作能力提高最明 显。社会功能的改变（ SSPI 量表）两 组间也呈现明显差异（ P<0.001 ）。
  结论 : 手工 疗法对慢性衰退型精神病人康复是可行的，有明显促进作用。
  关键词 : 慢性衰退型精神病人 手工 疗法
  
  Object: To explore the rehabilitate effect of painting to chronic schizophrenic.
  Methods: Thirty male hospitalized schizophrenia patients are randomly divided into painting group and comparative group. The patients of painting group train for painting and creating. Every patient is evaluated before and after treatment by PANSS scale and life satisfaction scale.
  Result: The PANSS scale score and life satisfaction scale score of patient in painting group is higher than comparative group after painting therapy, the differences are statistically significant, P<0.05 。
  Conclusion: Painting therapy is helpful for improving symptoms and life quality of chronic schizophrenia patient, painting therapy is worth being promoted as an auxiliary treatment methods.
  Key words: painting therapy chronic schizophrenic rehabilitation
   
  
• P165
  绘画疗法对慢性精神分裂症和康复的探索 - Exploration of Painting Therapy for Chronic Schizophrenic and Rehabilitation
  孔 令 芳 1 , 钱 倩 2 , 盛 嘉 玲 3
  1 上海市民政第一精神病院 , 六病区 , 上海 , Chinese Mainland, 2 上海市民政第一精神病院 , 一病区 , 上海 , Chinese Mainland, 3 上海市民政第一精神病院 , 三病区 , 上海 , Chinese Mainland
  
  目的 : 探索 绘画治疗对慢性精神分裂症的康复效果。
  方法 : 30 例男性住院精神分裂症患者随机分 类为绘画组和对照组、绘画组进行绘画及创造作品的训练、并采用 PANSS 量表和生活 满意度量表于治疗前后对每一位患者进行评定。结果 绘画组治疗前后 PANSS 及生活 满意度量表评分均优于对照组 ， 差异均有显著性、 P<0.05 。
  结论 : 绘画组治疗对改善慢性精神分裂症的病人症状 ， 提高生活质量有一定的帮助 ， 绘画治疗作为一种辅助治疗的方法值得推广。
  关键词 : 绘画治疗 、慢性精神分裂症、康 复 .
  
  Object: To explore the rehabilitate effect of painting to chronic schizophrenic.
  Methods: Thirty male hospitalized schizophrenia patients are randomly divided into painting group and comparative group. The patients of painting group train for painting and creating. Every patient is evaluated before and after treatment by PANSS scale and life satisfaction scale.
  Result: The PANSS scale score and life satisfaction scale score of patient in painting group is higher than comparative group after painting therapy, the differences are statistically significant, P<0.05 。
  Conclusion: Painting therapy is helpful for improving symptoms and life quality of chronic schizophrenia patient, painting therapy is worth being promoted as an auxiliary treatment methods.
  Key words: painting therapy chronic schizophrenic rehabilitation
  
• P166
  心理社会干 预及 7 种抗精神病药对精神分裂症预后影响研究 - The Study on Prognosis for Patients with Schizophrenia Treating by Social-psychological Intervention and 7 Kinds of Antipsychotic Medicine
  效峰 国 1 , 靖平 赵 1 , 哲宁 刘 2
  1 中南大学湘雅二医院精神 卫生研究所 , 长沙 , Chinese Mainland, 2 中南大学湘雅二医院精神 卫生研究所 , 410011, Chinese Mainland
  
  目的 : 探 讨心理社会干预及 7 种抗精神病药对精神分裂症预后的改善作用。
  方法 : 多中心、 开放、随机、对照研究。总病期小于 5 年的 稳定期精神分裂症随机分为综合组 （ 抗精神病药结合心理社会干预 ） 和标准组 （ 抗精神病药与一般精神卫生服务 ）， 随访一年。主要结局指标为治疗终止率、自知力和治疗依从性及生活质量。
  结果 1:
  1. 综合组终止率（ 28.2% ） 显著低于标准组（ 41.8% ）（ P<0.05 ）； 综合组复发率（ 12.9% ） 显著低于标准组（ 19.6% ）（ P<0.05 ）。
  2. 12 月末 , 两 组阳性及阴性症状量表（ PANSS ） 总分、临床总体印象量表 - 严重程度（ CGI-SI ）分均小于基 线， CGI-SI 变化值综合组大于标准组（ P<0.05 ）。
  3. 12 月末，两 组自知力与治疗态度问卷（ ITAQ ） 总分均增加，综合组 ITAQ 总分增加值大标准组（ P<0.05 ）。 综合组治疗依从性（ 84.1% ）均高于 标准组（ 75.4% ）（ P<0.05 ）。
  4. 12 月末，两 组 SF-36 8 项因子均改善， RP （生理 职能）、 GH （一般健康）、 VT （精力）及情感 职能（ RE ）因子 综合组改善值大于标准组（ P<0.05 ）。
  结果 2:
  1 ．治 疗终止率：氯丙嗪 (37.7%) 、舒必利 (30.4%) 、 氯氮平 (34.3%) 、利培 酮 (34.8%) 、奥氮平 (38.5%) 、奎硫平 (43.1%) 及阿立 哌唑 (17.6%) ； 7 组差异无显著性（ P>0.05 ）。
  2. 氯丙嗪锥体外系不良反应发生率高于舒必利、利培酮、奥氮平、奎硫平及阿立哌唑；氯丙嗪、舒必利、利培酮抗胆碱能药合并率较高；奥氮平体重增加发 生率高，利培 酮月经紊乱不良反应发生率高。
  3.7 种药物组 ITAQ 总分改善值差异均无显著性（ P>0.05 ）；治 疗依从性差异均无显著性 (P>0.05) 。
  4.SF-36 8 个因子分改善 值 7 种药物组间差异均无显著性 (P>0.05) 。
  结论 : 心理社会干 预可以改善精神分裂症的临床结局、自知力和治疗依从性及生活质量。
  7 种抗精神病药对预防精神分裂症复发的疗效相当。氯丙嗪、舒必利及利培酮有较强的锥体外系不良反应，奥氮平体重增加作用显著，利培酮致月经紊乱作用显著。生活质量的改善作用 7 种药物疗效相当。
  关键词 : 心理社会干 预 , 精神分裂症 , 抗精神病 药， 结局
   
  
• P167
  利培 酮与氯氮平维持治疗对精神分裂症患者生活质量的影响 - The Influence on Life Quality of Risperidone and Clozapine in Maintaining Treatment Patients with Schizophrenia
  永泉 郑 1 , 红君 许 1
  1 杭州市公安局安康医院 , 杭州市 , Chinese Mainland
  
  目的 : 探 讨利培酮与氯氮平对稳定期精神分裂症患者生活质量的影响。
  方法 : 将 60 例 稳定期精神分裂症患者分别予利培酮和氯氮平维持治疗 1 年，于入 组时和治疗后１年末分别采用阳性与阴性症状量表（ＰＡＮＳＳ）、健康状况调查问卷（ＳＦ－３６）、不良反应量表（ＴＥＳＳ）评定临床疗效、生活质量及不良反应。
  结果： 两 组患者ＰＡＮＳＳ总分、阳性症状分、阴性症状分及一般精神病理分同期比较差异无显著性，治疗后１年末两组评分均显著低于入组时，与入组时比较差异有显著性。治疗后１年末利培酮组ＳＦ－３６量表各因子分评分均高于氯氮平组，与氯氮平组比较差异有显著性。
  结论： 利培 酮与氯氮平治疗精神分裂症疗效相当，利培酮 更有利于改善患者的生活 质量。
   
  
• P168
  精神分裂症相 关的人内源性逆转录病毒基因的克隆、鉴定与蛋白表达 - Gene Cloning, Identification and Expression of Human Endogenous Retrovirus Correlation with Schizophrenia
  忠 纯 刘 1 , 高 华 王 2 , 帆 朱 3
  1 武 汉大学人民医院 , 精神 卫生中心 , 武 汉 , Chinese Mainland, 2 武 汉大学人民医院 , 武 汉 , Chinese Mainland, 3 武 汉大学 / 病毒学国家重点 实验室 , 武 汉 , Chinese Mainland
  
  目的： 研究人内源性逆 转录病毒（ human endogenous retrovirus ， HERV ）基因与精神分裂症相 关性及其可能的作用机制，克隆 HERV 基因，构建 HERV 基因的蛋白表达系 统。
  方法： 通 过提取精神分裂症患者外周血单个核细胞 (PBMCs) 的 总 RNA ，利用 RT-PCR 技 术 , 扩增 HERV 基因 , 然后将 该片段连接到 pGEM － T 载体，进行 PCR 检测阳性克隆并测序分析。纯化回收后克隆于原核表达载体 pET28a 中， 转 化大 肠杆菌 BL21 菌株， IPTG 诱导表达，进行 SDS － PAGE 与 Western 印迹分析与 鉴定。
  结果： 应用 RT － PCR 技 术 , 从精神分裂症患者外周血 单核细胞的总 RNA 中 扩增到一条大小约为 161bp 的片段 , 经 pGEM － T 载体克隆与测序鉴定 , 证实此片段为 HERV pol 基因。 纯化回收后克隆于原核表达载体 pET28a 中， 转化大肠杆菌 BL21 菌株， IPTG 诱导表达，进行 SDS － PAGE 与 Western 印迹分析与 鉴定证实：在相对分子量约 23kD 处见到明显的病毒特异性的高表达条带。
  结论： 已成功克隆了人内源性逆 转录病毒 pol 基因 , 并 经 IPTG 诱导 , 在大 肠杆菌 BL21 菌株中表达了相 应的病毒蛋白 , 为进一步研究该人内源性逆转录病毒与精神分裂症的相关性奠定基础。
   
  
• P169
  阿立 哌唑治疗精神分裂症疗效及生活质量对照研究 - Comparative Study on the Effect and Quality of Life of Aripiprazole on Patients with Schizophrenia
  学 军 王 1
  1 河南第二 荣康 , 洛阳 , Chinese Mainland
  
  目的： 探 讨阿立哌唑与氯氮平治疗精神分裂症的临床疗效、生活质量及药物副反应的差异。
  方法： 全部病例均符合 CCMD-3 精神分裂症 诊断标准，随机分为治疗组和对照组，分别给予阿立哌唑和氯氮平治疗，阿立哌唑 10 ～ 25 ㎎ / 日，平均 19.18±3.28 ㎎ , 氯氮平 100 ～ 400 ㎎ / 日，平均 247.8±69.2 ㎎ . 疗程共 8 周，治 疗 8 周后采用 阴性与阳性症状量表（ PANSS ）、 生活 质量综合评定问卷（ GQOLI-74 ）及 药物副反应量表（ TESS ） 进行评定。
  结果： 治 疗 8 周后，两 组临床有效率分别为 88.46 ％和 84.62 ％无 显著性差 异（ P ＞ 0.05 ）；两 组 PANSS 阴性症状量表分具有显著性差异（ p ＜ 0.05 ）； 对生活质量的改善治疗组明显优于对照组， GQOLI-74 评分除物质生活无显著差异外，其它均有显著性差异（ P ＜ 0.01 ）；治 疗组副反应发生率较低，且较轻微。
  结论： 阿立 哌唑其作用机制可能与其对 DA 受体和 5-HT1A 受体部分激 动作用及 DA 和 5-HT2A 的拮抗作用有 关，是 DA 和 5-HT 系 统的稳定剂。根据神经系统不同的功能状态发挥激动作用，维护神经系统正常的生理功能，缓解阳性、阴性症状，改善认知功能。两组治疗后 PANSS 阴性症状量表评 分具有 显著性差异，表明阿立哌唑对于改善精神分裂症阴性症状疗效优于氯氮平。由于阿立哌唑既能改善精神分裂症阳性症状，又对阴性症状有较好的临床效果，故其临床显效率较高，对精神分裂症精神症状改善效果较好。
  治 疗组药物副反应一般较轻，主要有头痛、恶心、焦虑、失眠等，对血常规、肝功能及体重影响较小，与对照组相比不良反应发生率明显较低，提高了患者临床服药依从性。治疗后两组在 GQOLI-74 生活 质量、躯体功能、心理功能及社会功能等方面差异均具有显著性。这可能与阿立哌唑对于改善精神分裂症阴性症状、认知功能效果较好，且临床副作 用 较小有关，使患者保持良好的精神状态，提高了其工作、学习、人际交往能力，改善了患者的认知功能，从而使患者的生活质量得到了明显改善。
   
  
• P170
  总之 ， 阿立哌唑是一种临床安全有效的非典型抗精神病药物 ， 改善了患者的认知功能 ， 提高了生活质量及临床用药依从性 - Canparative Study the Curtive Effects and Having Gnalities in the Treatment of Aripiprazsle in Schizophrenia
  学 军 王 1
  1 河南第二 荣康医院 , 洛阳 , Chinese Mainland
  
  Objective: To study the drfferences about clinical curative effects. Liviny gualities and side effects between Aripiprazole and clozapine.
  Method: In the cases that conform to CCMD-3 were divided into treatiny group and contrasting group stoch as tically. They were treated by Aripiprazole with the dosage of 10-25mg/day. on average 19.18±3.28mg. and by clozapine with the dosage of 100-400mg/dny on averge 247.8±69.2mg/day. respectively. The course of treatment was 8 weeks.after 8 weeks the cases were evaluated by PANSS. GQOLI-74 and TESS.
  Results: After 8 weeks effective rate were respectively 88.46 ％ and 84.62 ％ .which has no remarkable discrepancy(p ﹥ 0.05).There were remarkable drscrepancy between the two PANSSes with negative symptoms(p ﹤ 0.05).The curative effect for improiny liviny gualities in treating group is superior to that in contrasting group obviously. There were remarkable discrepancies except substame life in GQOLI-74(p ﹤ 0.01).The side effect was slighter and the happening rate was laver.
  Conclusions: The fnnction mechanism of Aripiprazole may be related to it`s partical agitated effect of DA and 5-HT1a receptor and an tayitated effect of DA and 5-HT receptor.which is a stabliing druy on AD and 5-HT system. Aripiprazole takes ayitating effect auordiny to different function stakes of nervons system. upholds normal physical function of nervous system. soothes posicive and negative symptom and improves congnitive function. The remarkable discropancy in PANSS with negative symptoms between the two gronps after the treatment shows that the cnrative effect of Aripiprazole in improiny negative symptoms of schizophrenia is superior to that of Clozapine. The clinical effect of Aripiprazole is better since it can imprdve both positire and negative symtoms of schizophrenia.
   
  
• P171
  首 发精神分裂症听觉 P50 变异及康复过程中 的 动态观察 - The Variability of Auditory Evoked Potential P50 and Dynamic Observation in Process of Rehabilitation in Patients with First-episode Schizophrenia
  兴时 陈 1 , 云翔 唐 1 , 明 岛 张 1 , 红星 王 1 , 翡 璎 楼 1 , 建 华 梁 1 , 冲 陈 1
  1 上海市精神 卫生中心 , 上海 , Chinese Mainland
  
  目的 ： 听 觉 P50 是最常被用来 检测感觉门的 神 经电生理学研究方法。已知感觉门异常是导致精神分裂症患者产生精神症状的重要证据之一。本研究采用首发的精神分裂症为研究对象，通过跟踪随访部分患者论证精神分裂症 P50 指 标的变异性质。
  方法： 应用美国 Bravo 脑电生理仪，采用条件刺激（ S1 ） — 测试刺激（ S2 ）模式 对 66 例首 发精神分裂症患者（男 39 例，女 27 例，平均 28±6 岁，入组时阳性和阴性症状量表评分总分 121.5±15.9 分）和 92 名健康 对照者（其中男 52 名，女 40 名，年 龄 21~43 岁，平均年龄 25±5 岁，平均受教育年限 15.7±1.3 年。身心健康， 临床常规 精神 检查未发现任何精神障碍和智能缺陷及躯体疾病。无酒精或药物滥用史。一级亲属无重性精神病史）作了听觉 P50 检测，并用阳性和阴性症状量表（ PANSS ） 评定患者临床症状。患者组于治疗 5 周和 10 周 时进行 P50 随 访。
  结果： （ 1 ）精神分裂症 P50 抑制明 显减弱（ S2/S1 比率 正常 组 42±21 ％，患者 组 86±42 ％， P<0.01 ）； S2-P50 波幅正常人 2±1 ，患者 组 3±1 ， P<0.01 。 （ 2 ） 反映感 觉门 P50 大小的指 标 S2/S1 、 S1-S2 和 100 （ 1-S2/S1 ） 与 PANSS 无相 关性。（ 3 ）患者 组在治疗后的 5 周和 10 周随 访时的 P50 主要指 标差异也无显著性（ P>0.05 ）。
  结论： 研究中 选用 PANSS 总分及其阴性症状、阳性症状、一般状况等分量表分，以及反映缺乏、思维障碍、激活性偏执、抑郁 5 种症状的评分进行分析。结果未发现反映感觉门 P50 大小的指 标 S2/S1 、 S1-S2 和 100 （ 1-S2/S1 ）与 PANSS 有相 关性。提示本组首发精神分裂症 SG 缺 损可能是反映疾病素质的指标。而与疾病的严重程度关系不大。提示药物对 P50 指 标的影响在首发精神分裂症患者变异中不占主要地位。上述 P50 异常是精神分裂症本身存在的一 种素质因素，而并非 是数字的改 变。 SG 缺 损可能是精神分裂症的重要发病机制之一。
  
  
  

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