氯氮平和氯丙嗪维持治疗期精神分裂症认知功能与述情障碍比较  

The comparative study of cognitive functions and alexithymia between schizophrenic patients treated with clozapine and those treated with chlorpromazine

作　　者：刘军军[1,2] 张向荣[3] 吴兵 陈伟 龚有山 邹玉青 邵阿林 

机构地区：[1]南京大学医学院,南京210041 [2]上海梅山医院医学心理科 [3]南京医科大学附属脑科医院老年精神科

出　　处：《中国神经精神疾病杂志》2015年第10期618-623,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(编号:91132727;81371474);江苏省自然科学基金(编号:BK2012747)

摘　　要：目的比较以氯氮平和氯丙嗪维持治疗的精神分裂症患者的认知功能与述情障碍。方法分别纳入以氯氮平、氯丙嗪维持治疗且病情稳定的男性精神分裂症患者各24例,以及男性正常对照24名。采用数字划消测验、言语流畅性测验、连线测验A和B、动物命名测验、Stroop色—词测验、韦氏智力测验中国版木块图、空间广度测验等神经心理测验评估三组被试的认知功能,并采用多伦多述情障碍量表(the twenty-item Toronto alexithymia scale,TAS-20)评估被试述情障碍。结果两患者组所有神经心理测验得分均低于对照组(P=0.02),两患者组TAS-20各因子分及总分均高于对照组(P<0.01),两患者组之间认知功能及述情障碍评分差异均无统计学意义(P>0.05)。多因素线性回归分析显示,氯氮平组注意功能与TAS总分(β=-0.20,P=0.02)相关联,执行功能与TAS情感辨别能力因子(β=-0.26,P=0.03)相关联,空间功能与TAS情感描述能力因子(β=-0.24,P<0.01)相关联;氯丙嗪组注意功能与TAS情感描述能力因子(β=-1.24,P<0.01)相关联,执行功能与TAS情感描述能力因子(β=-0.33,P=0.02)相关联。结论精神分裂症患者在药物维持治疗期仍存在广泛的认知功能损害及述情障碍,且认知损害与述情障碍间具有一定关联。Objective To compare cognitive function and alexithymia between the schizophrenic patients treated with chlorpromazine and those treated with clozapine. Methods The patients with schizophrenia in stable condition that received maintenance treatment either with chlorpromazine or clozapine and normal control subjects were recruited （n=24 per group）. Neuropsychologieal tests, including Digit Vigilance Test, Controlled Oral Word Association Test, Trail Making Test-A ＆ B （TMT-A ＆ B）, Animal Naming Test, Stroop Color-Word Test, Block Design and Spatial Span Test were used to assess the participant＇ s cognitive function. The twenty-item Toronto Alexithymia Scale （TAS-20） were used to evaluate the participant＇ s alexithymia. Results The significant differences were found between the patients and the controls in all items of cognitive function and all factor scores of TAS-20 （P 〈0.05）. There were no significant differences in all items of cognitive function and all factor scores of TAS-20 between chlorpromazine group and clozapine group （P 〉0.05）. Multivari-ate linear regression analysis showed that in the clozapine group, attention function associated with the total score of TAS （β=-0.20, P〈0.05）, executive function associated with TAS factor 1 （β=-0.26, P=-0.03）, spatial function associated with TAS factor 2 （β=-0.24, P〈0.01）. In the chlorpromazine group, attention function associated with TAS factor 2 （β=-1.24, P 〈0.01）, executive function associated with TAS factor 2 （β=-0.33, P=0.02）. Conclusions Patients with schizophrenia in maintenance period have widely cognitive impairment and alexithymia, both of which are related to each other.

关 键 词：精神分裂症 认知功能 述情障碍 

分 类 号：R749.3[医药卫生—神经病学与精神病学]