比较鲁拉西酮与奥氮平治疗精神分裂症的临床效果及对患者认知功能的影响  

Comparison of the Clinical Efficacy and Impact on Cognitive Function of Lorazepine and Olanzapine in the Treatment of Schizophrenia

作　　者：李公权 曹琳佳 谢清芳[1] LI Gongquan;CAO Linjia;XIE Qingfang(Baoshan District Mental Health Center,Shanghai 201906)

机构地区：[1]上海市宝山区精神卫生中心,上海201906

出　　处：《医学临床研究》2025年第3期437-440,共4页Journal of Clinical Research

摘　　要：【目的】比较鲁拉西酮与奥氮平治疗精神分裂症的临床效果及对患者认知功能的影响。【方法】选择2020年8月至2023年12月上海市宝山区精神卫生中心收治的116例精神分裂症患者,采用随机数字表法分为鲁拉西酮组和奥氮平组,每组58例。两组患者均治疗持续12周,比较两组患者的临床症状改善情况、认知功能、神经功能生化指标[神经生长因子(NGF)、γ-氨基丁酸(GABA)、特异性烯醇化酶(NSE)]、炎症及代谢指标[白细胞介素-4(IL-4)、白细胞介素-8(IL-8)、甘油三酯(TG)、体重指数(BMI)]、不良反应发生情况。【结果】两组阴性与阳性症状量表(PANSS)评分均低于治疗前,且鲁拉西酮组低于奥氮平组,差异均有统计学意义(P<0.05)。治疗第4周、治疗第12周,两组MATRICS共识认知成套测验(MCCB)评分均高于治疗前,鲁拉西酮组高于奥氮平组,差异均有统计学意义(P<0.05)。治疗后,两组血清NGF、GABA水平均高于治疗前,且鲁拉西酮组高于奥氮平组,差异有统计学意义(P<0.05);两组血清NSE水平均低于治疗前,且鲁拉西酮组低于奥氮平组,差异有统计学意义(P<0.05)。治疗后,两组血清IL-4、IL-8水平均低于治疗前,且鲁拉西酮组低于奥氮平组;鲁拉西酮组BMI、TG低于治疗前,且低于奥氮平组,差异有统计学意义(P<0.05)。治疗后,奥氮平组BMI、TG与治疗前比较,差异无统计学意义(P>0.05)。鲁拉西酮组不良反应总发生率为8.62%(5/58),低于奥氮平组的24.14%(14/58),差异有统计学意义(P=0.024)。【结论】鲁拉西酮能够改善精神分裂症患者的认知功能,降低炎症因子水平,并且不会增加精神分裂患者代谢紊乱的发生风险,不良反应发生率低,安全性较好。【Objective】To compare the clinical efficacy and their impact on patients'cognitive function of lurasidone and olanzapine in the treatment of schizophrenia.【Methods】A total of 116 patients with schizophrenia admitted to Baoshan District Mental Health Center in Shanghai from August 2020 to December 2023 were selected and randomly divided into two groups using a random number table:the lurasidone group and the olanzapine group,with 58 patients in each group.Both groups of patients were treated for 12 weeks,and their clinical symptom improvement,cognitive function,biochemical indicators of neurological function[nerve growth factor(NGF),gamma aminobutyric acid(GABA),specific enolase(NSE)],inflammatory and metabolic indicators[interleukin-4(IL-4),interleukin-8(IL-8),triglycerides(TG),body mass index(BMI)],and incidence of adverse reactions were compared.【Results】The scores of the Negative and Positive Symptom Scale(PANSS)in both groups were lower than those before treatment,and the PANSS scores in the lurasidone group were lower than those in the olanzapine group,with statistically significant differences(P<0.05).At the 4th and 12th week of treatment,the MCCB scores of both groups were higher than those before treatment,and the MCCB score of the lurasidone group was higher than that of the olanzapine group,with statistical significance(P<0.05).After treatment,the levels of serum NGF and GABA in both groups were higher than those before treatment,and the levels of serum NGF and GABA in the lurasidone group were higher than those in the olanzapine group,with statistical significance(P<0.05).The serum NSE levels in both groups were lower than those before treatment,and the level in the lurasidone group was lower than that in the olanzapine group,with statistically significant difference(P<0.05).After treatment,the average levels of IL-4 and IL-8 in the serum of both groups were lower than those before treatment.The levels of IL-4 and IL-8 in the lurasidone group were lower than those in the olanzapine group.Th

关 键 词：精神分裂症 盐酸鲁拉西酮 奥氮平 认知 治疗结果 

分 类 号：R749.3[医药卫生—神经病学与精神病学]