抗精神病药治疗对稳定期精神分裂症患者认知功能的影响  

Effects of six kinds of antipsychotic drugs on their cognitive function of schizophrenia patients in stable stage

作　　者：肖晓杨[1] 谭小林[1] 林晖[1] 傅义容[1] 徐琳[2] 

机构地区：[1]重庆市精神卫生中心,401147 [2]重庆市医学会,400012

出　　处：《重庆医学》2010年第4期438-439,441,共3页Chongqing medicine

摘　　要：目的评价6种抗精神病药治疗对稳定期精神分裂症患者认知功能的影响。方法收集稳定期分裂症患者69例,分入氯丙嗪、舒比利、氯氮平、喹硫平、利培酮、阿立哌唑等6个药物治疗组。将威斯康星卡片分类测验(WCST)、连续操作测验(CPT)、连线测验A(TMT-A)、视觉再生测验(VR)、数字符号(DSy)及数字广度(DSp)等作为工具,于筛选入组时(基线)及随访6个月末进行认知功能评定。结果(1)WCST评分比较:阿立哌唑组、氯丙嗪组及舒比利组患者仅完成分类数(W1)有明显改善(P<0.05),利培酮组W1及正确应答数(W2)两个指标均有改善(P<0.05),氯氮平组与喹硫平组W1、W2及持续错误数(W3)均有明显改善(P<0.05)。(2)氯氮平组基线W1分值明显低于利培酮组(P=0.045),而6个月末明显高于利培酮组(P=0.031);氯氮平组基线视觉错误数(C1)明显高于其他各组(P=0.004),6个月末与各组差异无统计学意义(P=0.843)。(3)组间比较:喹硫平组DSy成绩优于利培酮组、氯氮平组(P=0.025、P=0.009);舒比利组除TMT-A分改善好于氯氮平组外(P=0.032),而在视觉漏报数(C2)及W3方面的改善明显小于其他各组(P=0.022)。结论经喹硫平治疗的患者认知功能改善最明显,其后依次为氯氮平、利培酮、阿立哌唑,疗效最差者为舒比利、氯丙嗪。Objective To evaluate the effect of six kinds of antipsychotic drugs on their cognition. Methods 69 schizophrenia patients in stable stage were brought into the study, and divided into six treatment groups, chlorderazin, dobren, clozapine, quetiapine, risperidone and aripiprazole, respectively. We evaluated their cognition functional at entering the group（base line） and the end of six month by WCST,CPT,TMT-A,VR,DSy,DSp. Results Comparison of WCST score：patients in aripiprazole,chlorderazin and dobren group only had a significant improvement of W1. Risperidone group had improvements of W1 and W2. Clozapine and quetiapine group improved in W1 ,W2 and W3. W1 score in clozapine group was significantly lower than that in risperidone group at baseline,while significantly higher at the end of six month. C1 in clozapine group was significantly higher than that in other groups, but no significance at the end of six month. Comparison of DS between groups：DS result in quetiapine group was superior to risperidone and clozapine group. Patients in dobren group only had a better improvement of TMT-A score than clozapine group, but lower improvement of C2 and W3 than other groups. Conclusion Basing on the cognition improvement,quetiapine is the best treatment for patients. Next come clozapine, risperidone and aripiprazole,and the third rank is given to dohren and chlorderazin.

关 键 词：稳定期精神分裂症 认知功能 抗精神病药 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R971.41[医药卫生—临床医学]