丙戊酸钠合并齐拉西酮或奥氮平对双相障碍Ⅰ型患者认知功能影响的比较  

Comparing the effect on cognitive function between valproate adding ziprasidone or olanzapine in patients with bipolar disorder Ⅰ type

作　　者：李烜[1] 关力杰[1] 温光池[1] 林晓鸣[1] 梁卉薇[1] 邓文皓[1] 常青[1] 欧玉芬 叶碧瑜[1] 苗国栋[1] 

机构地区：[1]广州市惠爱医院(广州市脑科医院),510370

出　　处：《临床精神医学杂志》2016年第1期26-28,共3页Journal of Clinical Psychiatry

摘　　要：目的:比较丙戊酸钠联合齐拉西酮或奥氮平对双相障碍I型(BD-I)患者认知功能影响。方法:将BD-I患者随机分为齐拉西酮组(59例,丙戊酸钠+齐拉西酮)和奥氮平组(61例,丙戊酸钠+奥氮平),并给予相应的药物治疗8周。分别于治疗前后应用贝克躁狂量表(BRMS)评定病情,应用数字符号、数字广度、视觉图形再生测验、连线测验(TMT)、言语流畅性测验、威斯康星卡片分类测验(WCST)及汉诺塔(TOH)评估认知功能。结果:治疗后两组BRMS评分较治疗前显著下降,两组间差异无统计学意义;治疗后两组认知功能均有不同程度的改善,在控制BRMS评分、年龄、病程后,齐拉西酮组的数字符号、数字广度顺背、数字广度总分、WCST分类数、TOH总分明显优于奥氮平组(F=3.61,10.24,12.51,4.69,4.27;P均<0.05)。结论:丙戊酸钠联合齐拉西酮或奥氮平均能改善BD-I患者的认知功能,但联合齐拉西酮对认知功能的改善更佳。Objective： To compare the effect on cognitive function between valproate adding ziprasidone or olanzapine in patients with bipolar disorder I type （BD-I）. Method：BD-I patients were ramdowly divided into ziprasidone group （ 59 cases, valproate ＋ ziprasidone） and olanzapine group （ 61 cases, valproate ＋ olanzap- ine） ,and treated with corresponding drugs for 8 weeks. The condition of patients were assessed by Bech-Rafaels- en mania rating scale （BRMS） , and cognitive function were evaluated by digital symbol, digital span, trail mark- ing test （TMT） A and B,visual reproduction,verbal fluency,Wisconsin card sorting test（WCST） ,tower of Ha- noi （TOH） before and after treatment, respectively. Results ： After treatment the BRMS scores of the two groups were decreased significantly than before treatment, the difference between the two groups had no statisti- cal significance. Cognitive function in the two groups had improved in different degrees. After controlling the fac- tors such as BRMS score, age, course of the disease, the results of digital symbol, digital span, digital span, quantity of WCST classification and TOH total scores in ziprasidone group were significantly better than those in olanzapine group（ F = 3. 61,10. 24 ,12. 51, 4. 69 , 4. 27 ; all P 〈0.05）. Conclusion：The cognitive function can be improved in BD-I patients treating with valproate adding ziprasidone or olanzapine ; but valproate adding ziprasidone is better.

关 键 词：双相障碍Ⅰ型 认知功能 奥氮平 齐拉西酮 丙戊酸钠 

分 类 号：R749.4[医药卫生—神经病学与精神病学]