利培酮和氯氮平对精神分裂症患者P_(300)影响的随机对照研究  

A comparative study of P_(300) potentials in schizophrenia treated with risperidone and clozapine.

作　　者：米国琳[1] 蒋燕敏[1] 栾习云[1] 陈忠[1] 陈彦方[1] 

机构地区：[1]山东省精神卫生中心,济南250014

出　　处：《精神医学杂志》2009年第4期259-261,共3页Journal of Psychiatry

摘　　要：目的探讨精神分裂症患者P300的变异,以及氯氮平和利培酮对P300的影响。方法63例精神分裂症患者随机分为利培酮组(32例)和氯氮平组(31例),进行双盲给药治疗6周。阳性和阴性症状量表(PANSS)评定临床疗效,同时进行P300检测。结果双盲用药后第6周末,两组患者PANSS总分及各分量表分均明显低于第2周末,差异具有显著性,两组之间差异无显著性。与正常组比较,利培酮组和氯氮平组N1潜伏期、P3潜伏期、P3-N1潜伏期之差明显延长,P3波幅明显降低,差异均具有显著性。经利培酮和氯氮平治疗后两组患者潜伏期和波幅自身前后对比差异均无显著性,两组之间比较差异亦无显著性。氯氮平组患者PANSS阳性症状分与P300的P3潜伏期、P3-N1潜伏期显著负相关,阴性症状分和P3潜伏期明显正相关。利培酮组患者PANSS评分与P300各项指标无明显相关。结论利培酮和氯氮平均能有效治疗精神分裂症患者。精神分裂症患者P300潜伏期和波幅有明显异常,利培酮对P300无明显影响,而氯氮平可能影响P300的潜伏期。Objective To investigate P300 potentials in patients with schizophrenia, and the influence ot risperidone and clozapine on P300. Methods A total of 63 inpatients with schizophrenia were randomly assigned to risperidone group（n=32） or clozapine group （n=31） for the double-blind treatment of 6 weeks. Positive and Negative Symptom Scale（PANSS） was used to assess efficacy. The patients and normal controls were measured auditory event-related potential P300. Results After 6-week treatment, the total scores and factor-scores of PANSS in two groups were decreased significantly, and there were no significant differences between the two groups. Compared to normd controls, the patients of two groups had significantly longer latency periods of N1, P3,and P3-N1 ,and lower amplitude of P3. There were no significant differences in P300 between two groups before and after treatment. In clozapine group, the score of positive symptoms in PANSS had significantly negative relation with latency periods of P3 and P3-N1, and the score of negative symptoms had positive relation with latency period of P3. While no significant relations were found between scores of PANSS and P300 in risperidome group. Conclusion Risperidone and clozapine both have beneficial effect for patients with schizophrenia. The patients would have obvious abnormalities of P3o0. Risperidone could have no effects on P300, while clozapine may influence latency of P300.

关 键 词：精神分裂症 利培酮 氯氮平 P300 

分 类 号：R749.3[医药卫生—神经病学与精神病学]