鲁拉西酮与氨磺必利对阴性症状精神分裂症患者精神状态、认知功能影响的比较  

Comparison of Effects of Lurasidone and Amisulpride on Mental State and Cognitive Function in Patients with Negative Symptoms of Schizophrenia

作　　者：刘淇丰 郝新梅 LIU Qifeng;HAO Xinmei(Department of Psychosomatic Medicine,Qingdao Mental Health Center,Qingdao 266000,China)

机构地区：[1]青岛市精神卫生中心心身医学科,山东青岛266000

出　　处：《医学综述》2025年第3期372-376,384,共6页Medical Recapitulate

摘　　要：目的比较鲁拉西酮与氨磺必利对阴性症状精神分裂症(SCH)患者精神状态、认知功能的影响。方法选择2022年11月至2023年11月青岛市精神卫生中心收治的100例阴性症状SCH患者为研究对象,按照治疗方法不同分为鲁拉西酮组与氨磺必利组,各50例。鲁拉西酮组给予盐酸鲁拉西酮片口服治疗(起始剂量为每次40 mg,每日1次,后可结合需要最多增加到每次80 mg,每日1次),氨磺必利组给予氨磺必利片口服治疗(起始剂量为每次50 mg,后可调整至每次200 mg,每日2次),两组均治疗6周。比较两组患者治疗后的临床有效率、阴性症状[阴性症状评定量表(SANS)]、精神状态[简易精神状态检查量表(MMSE)]、认知功能[蒙特利尔认知评估量表(MoCA)]及不良反应发生率。结果两组总有效率比较差异无统计学意义(P>0.05)。治疗后,氨磺必利组思维贫乏、注意障碍、情感迟钝/平淡、兴趣/社交缺失、意志缺乏等各项SANS评分低于鲁拉西酮组[(10.1±2.2)分比(15.2±2.4)分、(5.4±1.0)分比(8.4±1.3)分、(15.4±1.4)分比(21.1±1.5)分、(9.6±1.2)分比(14.2±1.4)分、(8.7±1.4)分比(12.2±1.4)分](P<0.01)。治疗后,氨磺必利组患者记忆力、回忆能力、语言能力、计算力和注意力、定向力及总分等各项MMSE评分均高于鲁拉西酮组[(5.01±0.30)分比(4.26±0.33)分、(4.98±0.22)分比(4.14±0.29)分、(5.10±0.27)分比(4.30±0.31)分、(5.07±0.36)分比(4.28±0.39)分、(5.11±0.20)分比(4.19±0.40)分、(28.34±1.03)分比(27.17±1.27)分](P<0.01)。治疗后,氨磺必利组MoCA评分高于鲁拉西酮组[(28.5±1.3)分比(25.4±2.5)分](P<0.01)。氨磺必利组不良反应发生率高于鲁拉西酮组[30.0%(15/50)比12.0%(6/50)](χ^(2)=4.883,P=0.027)。结论阴性症状SCH患者采用鲁拉西酮和氨磺必利治疗均能取得良好效果,但前者不良反应少,而后者在减轻阴性症状、改善精神状态及提高认知功能方面作用更确切。Objective To compare the effects of lurasidone and amisulpride on mental status and cognitive function in patients with negative symptoms of schizophrenia(SCH).Methods A total of 100 patients with negative symptoms of SCH admitted to Qingdao Mental Health Center from Nov.2022 to Nov.2023 were included as the study subjects and divided into a lurasidone group and an amisulpride group according to different treatment methods,with 50 cases each.The lurasidone group was given oral treatment with lurasidone hydrochloride tablets(starting dose 40 mg each time,once a day,which could be increased to a maximum of 80 mg each time,once a day according to needs),and the amisulpride group was given oral treatment with amisulpride tablets(starting dose 50 mg each time,then adjusted to 200 mg each time,twice a day).Both groups were treated for 6 weeks.The clinical effective rate,negative symptoms[scale for assessment of negative symptoms(SANS)],mental status[mini-mental state examination(MMSE)],cognitive function[Montreal cognitive assessment(MoCA)]and incidence of adverse reactions were compared between the two groups after treatment.Results There was no significant difference in total effective rate between the two groups(P>0.05).After treatment,the SANS scores of poor thinking,attention disorder,emotional dullness/blandness,lack of interest/social interaction,and lack of will in the amisulpride group were lower than those of the lurasidone group(10.1±2.2 vs 15.2±2.4,5.4±1.0 vs 8.4±1.3,15.4±1.4 vs 21.1±1.5,9.6±1.2 vs 14.2±1.4,8.7±1.4 vs 12.2±1.4)(P<0.01).After treatment,the MMSE scores of memory,recall ability,language ability,calculation power,attention,orientation and total score in the amisulpride group were higher than those in the lurasidone group(5.01±0.30 vs 4.26±0.33,4.98±0.22 vs 4.14±0.29,5.10±0.27 vs 4.30±0.31,5.07±0.36 vs 4.28±0.39,5.11±0.20 vs 4.19±0.40,28.34±1.03 vs 27.17±1.27)(P<0.01).After treatment,the MoCA score of the amisulpride group was higher than that of the lurasidone group(28.5±

关 键 词：精神分裂症 鲁拉西酮 氨磺必利 认知功能 阴性症状 

分 类 号：R749[医药卫生—神经病学与精神病学]