碳酸锂联合富马酸喹硫平治疗双相情感障碍躁狂发作的疗效及对认知功能的影响  

Curative effect of lithium carbonate combined with quetiapine fumarate in the treatment of manic episodes of bipolar disorder and its influence on cognitive function

作　　者：黄惠红 陈结南 HUANG Hui-hong;CHEN Jie-nan(Department of Pharmacy,Jing'an Mental Health Center,Shanghai 200436,CHINA;Department of Psychology,Jing'an Mental Health Center,Shanghai 200436,CHINA)

机构地区：[1]上海市静安区精神卫生中心药剂科,上海200436 [2]上海市静安区精神卫生中心心理科,上海200436

出　　处：《海南医学》2021年第18期2345-2348,共4页Hainan Medical Journal

摘　　要：目的观察碳酸锂联合富马酸奎硫平治疗双相情感障碍躁狂发作的疗效及对患者认知功能的影响。方法选取2016年1月至2020年10月静安区精神卫生中心收治的240例双相情感障碍躁狂发作患者作为研究对象,按随机数表法分为观察组和对照组,每组120例。对照组患者给予碳酸锂治疗,观察组患者在对照组治疗的基础上给予富马酸喹硫平片治疗,持续治疗4周。比较两组患者治疗前后的Bech-Rafaelsen躁狂评估量表(BRMS)评分、阴性综合症状量表(PANSS)评分、威斯康星卡片分类测验(WCST)、言语记忆测验(HVLT-R)、持续操作测验(CPT)、肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、白介素-6(IL-6)等炎症因子水平及治疗后的总有效率和不良反应发生情况。结果观察组患者的治疗总有效率为90.83%,明显高于对照组的72.50%,差异有统计学意义(P<0.05);两组患者治疗前的BRMS、PANSS、WCST、HVLT-R、CPT、TNF-α、IL-1、IL-6比较差异均无统计学意义(P>0.05);治疗后,观察组和对照组患者的BRMS[(8.53±2.12)分vs(14.61±3.39)分]、PANSS[(38.42±4.68)分vs(49.71±5.03)分]、TNF-α[(112.19±18.27)ng/L vs(146.75±18.83)ng/L]、IL-1[(73.28±10.76)ng/L vs(95.72±12.31)ng/L]、IL-6[(33.59±4.43)pg/mL vs(39.26±4.87)pg/mL]比较,观察组明显低于对照组,CPT[(3.29±0.63)分vs(2.78±0.56)分]比较,观察组明显高于对照组,差异均有统计学意义(P<0.05);两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。结论碳酸锂联合富马酸奎硫平治疗双相情感障碍躁狂发作安全有效,且能提高患者的认知功能,降低炎症水平,值得临床推广应用。Objective To observe the efficacy of lithium carbonate combined with quetiapine fumarate in the treatment of manic episodes of bipolar disorder and its effect on cognitive function,so as to provide reference for clinical treatment.Methods A total of 240 patients with manic episodes of bipolar disorder admitted to Jing'an Mental Health Center from January 2016 to December 2020 were selected as the research objects,and they were randomly divided into an observation group and a control group according to the random number method,with 120 patients in each group.The control group was treated with lithium carbonate,and the observation group was treated with quetiapine fumarate tablets on the basis of the treatment of the control group for 4 weeks.The Bech-Rafaelsen Mania Rating Scale(BRMS)score,Positive and Negative Syndrome Scale(PANSS)score,Wisconsin Card Sorting Test(WCST),Verbal Memory Test(HV-LT-R),Continuous Operation Test(CPT),tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6)levels,total effective rate,and adverse reaction rate after treatment were compared between the two groups before and af-ter treatment.Results After treatment,the total effective rate of treatment in the observation group was significantly higher than that in the control group(90.83%vs 72.50%,P<0.05).Before treatment,there was no significant difference between the observation group and the control group in BRMS,PANSS,WCST,HVLT-R,CPT,TNF-α,IL-1,IL-6(P>0.05);after treatment,the observation group was significantly lower than the control group in the following indexes(P<0.05):BRMS,(8.53±2.12)points vs(14.61±3.39)points;PANSS,(38.42±4.68)points vs(49.71±5.03)points;TNF-α,(112.19±18.27)ng/L vs(146.75±18.83)ng/L;IL-1,(73.28±10.76)ng/L vs(95.72±12.31)ng/L;IL-6,(33.59±4.43)pg/mL vs(39.26±4.87)pg/mL;after treatment,the observation group was significantly higher than the control group in CPT:(3.29±0.63)points vs(2.78±0.56)points(P<0.05).There was no significant difference in the incidence of adverse reac-tions betwe

关 键 词：碳酸锂 富马酸奎硫平 双相情感障碍 躁狂发作 认知功能 

分 类 号：R749[医药卫生—神经病学与精神病学]