氨磺必利和喹硫平对老年精神分裂症的疗效和认知功能的影响  

Clinical efficacy and effect on cognitive function of Amisulpride vs.Quetiapine in senile schizophrenic patients

作　　者：戴梅竹 张新风[1] 刘长成[1] 徐琼[1] 

机构地区：[1]湖北省荆州市精神卫生中心,434000

出　　处：《精神医学杂志》2014年第3期197-200,共4页Journal of Psychiatry

摘　　要：目的探讨氨磺必利与喹硫平对老年精神分裂症患者临床疗效和认知功能的影响。方法采用双盲随机平行对照的方法,将98例老年精神分裂症患者分为研究组和对照组各49例,研究组接受氨磺必利治疗,对照组接受喹硫平治疗,疗程8周。治疗前后采用韦氏成人智力量表(WAIS)、威斯康星卡片分类测验(WCST)及临床记忆量表评价认知功能,采用阳性和阴性综合征量表(PANSS)和治疗中需处理的不良反应症状量表(TESS)评价临床疗效和药物不良反应。结果研究组和对照组有效率分别为89.36%和81.82%,两组有效率比较无显著性差异(χ2=1.06,P﹥0.05);治疗后第2、4、8周末两组PANSS总分及各因子分与治疗前比较显著下降(P<0.05);研究组治疗后第4、8周末阴性症状、PANSS总分显著低于对照组(P<0.05);治疗后第8周末两组认知功能都有一定程度的改善,但研究组WAIS量表的操作智商,临床记忆量表的联想学习、图像自由回忆、记忆商数,以及WCST量表的正确百分数、随机错误数均较对照组改善更为明显(P<0.05);两组不良反应均较轻微,不良反应发生率比较无显著性差异(P>0.05)。结论氨磺必利能明显改善老年精神分裂症患者的认知功能,不良反应轻,值得临床应用。Objective To compare the clinical efficacy and effect on cognitive function between amisulpride and quetiapine in the treatment for senile schizophrenic patients. Methods The study was a randomized, double-blind, parallel controlled study. 98 hospitalized patients with senile schizophrenia were randomized into study group （49 cases） treated with amisulpride and control study （49 cases） treated with quetiapine for 8 weeks. All patients were assessed with Wechsler Adult Intelligence Scale （ WAIS）, Wisconsin Card Sorting Test （WCST） and clinical memory scale at baseline and at the end of the 8-week treatment to evaluate their cognitive function. They were assessed with Positive and Negative Syndrome Scale （PANSS） and Treatment Emergent Symptom Scale （TESS） at baseline and at the end of the 2nd, 4th, 8th week to evaluate the clinical efficacy and adverse drug reaction. Results There was no significant difference in effective rate between study group and control group （89.36% vs. 81.82%, X2 = 1.06, P 〉 0.05）. Total score and all factor scores of PANSS in both groups decreased significantly at week 2, week 4 and week $ when compared with the baseline （P 〈 0. 05）. Total score of PANSS and factor score of negative symptoms at week 4, week 8 in study group were significantly lower than those in control group （ P 〈 0.05 ）. At the end of the 8- week treatment, cognitive function were improved to some extent in both groups, but study group showed significantly better improvement in performance IQ of WAIS, associative learning, image free recall, memory quotient of clinical memory scale, and correct percentage, number of random errors of WCST （ P 〈 0.05 ）. Adverse reactions were mild in both groups and there was no significant difference in incidence rate of adverse reactions between the two groups （ P 〉 0. 05 ）. Conclusion Amisulpride can improve the cognitive function of senile schizophrenia effectively with less adverse reactions. It is worthy of clinical application.

关 键 词：老年精神分裂症 认知功能 氨磺必利 喹硫平 

分 类 号：R749.3[医药卫生—神经病学与精神病学]