阿立哌唑与利培酮对精神分裂症患者的临床疗效及认知功能的影响  

Clinical effect and influence in cognitive function of aripiprazole and risperidone in patients with schizophrenia

作　　者：刘旭[1] 程哲[1] 杨芳 程传宝[1] 

机构地区：[1]河南省精神病医院精神科,新乡市453002 [2]新乡市牧野医院

出　　处：《职业与健康》2013年第3期294-297,共4页Occupation and Health

摘　　要：目的探讨阿立哌唑与利培酮治疗精神分裂症患者的临床疗效和安全性以及对患者认知功能的影响。方法将156例精神分裂症患者随机分为2组,每组78例,研究组口服阿立哌唑治疗,对照组口服利培酮治疗,观察8周。于治疗前及治疗4周、8周末采用阳性与阴性量表及临床总体印象量表评定临床疗效,副反应量表评定不良反应。于治疗前及治疗8周末采用韦氏成人智力量表、韦氏记忆量表、韦斯康星卡片分类测验评定患者的认知功能。对2组上述测评结果进行对比分析。结果从治疗第4周末起,2组阳性与阴性症状量表总分、阳性症状、阴性症状、一般病理因子分和临床总体印象量表评分均较治疗前有显著下降,差异均有统计学意义(P<0.01);同期2组间评分比较,差异均无统计学意义(P>0.05)。治疗8周末,研究组显效率73.08%,有效率96.15%;对照组分别为71.79%、92.31%,2组比较,差异均无统计学意义(χ2=0.032、0.806,P>0.05)。治疗8周末,2组患者韦斯康星卡片分类测验中的错误应答数及非持续性错误均较治疗前有显著性下降,而韦氏记忆量表中的再认、再生、理解、记忆商因子分均显著高于治疗前,差异均有统计学意义(P<0.05或<0.01);而同期2组间比较差异均无统计学意义(P>0.05)。2组不良反应均轻微,多出现在治疗初期;研究组锥体外系反应、月经失调、泌乳及体重增加的发生率均显著低于对照组,差异均有统计学意义(P<0.01);其他不良反应发生率2组差异均无统计学意义(P>0.05)。结论阿立哌唑治疗精神分裂症疗效显著,能显著改善患者的阳性症状、阴性症状、一般病理症状和认知功能,提高患者的生活质量,总体疗效与利培酮相当,且不良反应轻微,安全性更高,依从性更好,可作为治疗精神分裂的一线药物在临床中推广使用。[ Objective ] To explore the clinical effect and safety of aripiprazole and risperidone in patients with schizophrenia, and the influence in cognitive function of patients. [ Methods] 156 schizophrenia patients were randomly divided into two groups, 78 cases in each group. The research group was treated with aripiprazole orally, and the control group was given risperidone, for 8 weeks. Before treatment and at the end of the 4th and 8th week of treatment, the clinical effect was assessed with the Positive and Negative Syndrome Scale （PANSS） and the Clinical Global Impression （CGIS）, and the adverse reactions were evaluated with the Treatment Emergent Symptom Scale （TESS）. Before treatment and at the end of the 8th week of treatment, the cognitive functions of patients was assessed with the Wechsler Adult Intelligence Scale （ WAIS）, the Wechsler memory scale （ WMS ） and the Wisconsin Card Sorting Test （WCST）. The evaluation results of two groups were analyzed and compared. [ Results] At the end of 4th week of treatment, the total and each factors scores of PANSS, as well as CGIS score decreased significantly as compared with those before treatment （ P 〈 0.01 ）. There was no significant difference in scores between two groups during the same period （ P 〉 0.05 ）. At the end of 8th week of treatment, the obvious effective rate and effective rate in the research group was 73.08% and 96.15% re- spectively, and that in the control group was 71.79% and 92.31% respectively, which showed no significantly difference （ χ2 = 0. 032, 0.806,P 〉 0.05 ）. At the end of 8th week, the error answers and non-persistent error of WCST of two groups decreased significantly than those before treatment, while factor scores of WMS in the recognition, regeneration, eomprehension, memory quotient were significantly higher than those before treatment （P 〈 0.05 or P 〈 0.01 ） , and there was no significant differ- ence between two groups during the same period （ P 〉 0.05 ）. Adverse reaction

关 键 词：精神分裂症 阿立哌唑 利培酮 认知功能 临床疗效 不良反应 阳性与阴性量表 临床总体印象量表 韦氏成人智力量表 韦氏记忆量表 韦斯康星卡片分类测验 

分 类 号：R453[医药卫生—治疗学]