利培酮和氯氮平对精神分裂症患者自发性脑活动的不同影响  

Different effects of taking risperidone and clozapine on spontaneous brain activity in schizophrenics

作　　者：李娇婷 许昊[1] 杨黄浩[1] 常鑫[1] 段明君[1,2] 罗程[1] 尧德中[1] 

机构地区：[1]电子科技大学,四川成都610054 [2]成都市第四人民医院,电子科技大学成都脑科学研究院,四川成都610036

出　　处：《四川精神卫生》2017年第1期27-31,共5页Sichuan Mental Health

基　　金：国家自然科学基金(81471638)

摘　　要：目的探究利培酮和氯氮平对精神分裂症患者自发性脑活动造成的不同影响。方法采用横断面研究方法,选取2014年6月-2015年6月在成都市第四人民医院住院并分别接受利培酮(n=10)和氯氮平(n=11)治疗的精神分裂症患者为患者组,同期选取10名正常健康被试为对照组。采集每名被试的静息态fMRI数据,计算其低频振幅(ALFF)指标,使用协方差分析方法考察三组被试的组间差异,并采用事后检验进行两两比较。结果①三组被试的年龄、性别、受教育年限差异均无统计学意义(P均>0.05);②三组被试在双侧丘脑、脑岛、小脑半球、颞中回以及左侧辅助运动区、眶部额中回、左侧梭状回和中央后回的ALFF值差异均有统计学意义(P<0.05),事后检验显示两患者组在双侧丘脑和左侧辅助运动区的ALFF值较对照组低;其中,氯氮平组在双侧小脑半球、左侧眶部额中回和左侧梭状回的ALFF值高于对照组,而在双侧脑岛及左侧中央后回的ALFF值低于对照组;氯氮平组在双侧颞中回及左侧中央后回的ALFF值较利培酮组低,而在左侧眶部额中回的ALFF值高于利培酮组,差异均有统计学意义(P均<0.05)。结论氯氮平和利培酮均可能对精神分裂症患者不同脑区的自发性活动造成不同影响,而氯氮平影响更多的脑区自发性活动,这有助于理解两种药物对大脑的不同药理效应。Objective To explore the difference effects of taking two different kinds of drugs （ risperidone and clozapine ） , on spontaneous brain activity in patients with schizophrenia respectively. Methods A cross - sectional study, 10 patients taking risperidone（ RG） , 11 patients taking clozapine（ CG） and 10 health controls（HC） were recruited from The Forth People s Hospital of Chengdu from June 2014 to June 2015, were performed. The amplitude of low frequency fluctuation （ ALFF） on resting state of patients was calculated. The difference between groups was examined by covariance analysis method and compared each two of them through Post hoc analysis. Results There was no significant difference in age, gender or education among three groups （P 〉 0 . 05 ） . ②Covariance analysis showed difference of ALFF in the bilateral thalamus, insula, cerebellum, middle temporal gyms, and left supplementary motor area, middle frontal gyms（ Orb） and postcentral gyms（ P 〈 0. 05 ）. In Post hoc analysis, two patient groups showed decrease in the bilateralthalamus and supplementary motor area compared with HC. In addition, compared with the HC, the ALFF of CG was higher in bilateral cerebellum, left middle frontal gyms （Orb） and left fusiform gyrus, and lower in bilateral insula and left post central gyms. Moreover, compared with RG, the CG had lower ALFF in bilateral middle temporal gyms and left post central gyrus, while showed higher ALFF in left middle frontal gyms （Orb）. Conclusion This study shows that clozapine and risperidone have different effects on schizophrenia patients own spontaneous activity in different regions. Clozapine might influence more brain regions than risperidone in schizophrenia, which helps to understand the potential pharmacological effects on brain of two drugs.

关 键 词：精神分裂症 利培酮 氯氮平 静息态功能磁共振 低频振幅 

分 类 号：R749.3[医药卫生—神经病学与精神病学]