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奥氮平与利培酮对精神分裂症认知功能影响的对照研究
杜永慧,苏辉,沈辉,费慧,王丽华,陈妍
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摘要:
目的 比较两种非经典抗精神病药奥氮平、利培酮对精神分裂症病人认知功能的影响.方法 62例急性发病期的精神分裂症患者(包括首发与复发)为研究对象,随机分为两组,分别予以奥氮平、利培酮治疗12周,在基线和12周末分别用阳性与阴性症状量表(PANSS)及副反应量表(TESS)、韦氏智能测验的数字广度和数字符号测验、连线测验A、连线测验B、MMSE依次评价疗效、安全性、认知功能.结果 12周末时两组的PANSS量表总分和各因子分较基线时有显著差异,治疗后两组之间无统计学差异.12周末与基线时比较奥氮平在数字广度顺背数、数字符号、TMT-A连线时间、TMT-A正确数、TMT-B连线时间、MMSE比较差异有统计学意义(P<0.05).利培酮组在数字广度、数字符号、TMT-A连线时间、TMT-B连线时间、MMSE上有统计学的差异(P<0.05).12周末时,两组之间相比较,显示利培酮在数字广度顺背数、TMT-B连线时间比较差异有统计学意义(P<0.05).两组之间不良反应比较,利培酮组肌强直高于奥氮平组,差异有统计学意义(P<0.05).结论 奥氮平组和利培酮组治疗精神分裂症疗效相当,改善认知功能疗效相当,利培酮可能在改善注意方面优于奥氮平.
关键词:  精神分裂症  认知功能  奥氮平  利培酮
DOI:
基金项目:上海交通大学医学院附属精神卫生中心院级课题项目
A comparative study of olanzapine and risperidone on cognitive function in treatment of schizophrenia
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Abstract:
Objective To examine the effects of olanzapine and risperidone on cognitive function in treating schizophrenia. Methods Sixty two schizophrenics were assigned to receive olanzapine or risperidone treatment. The Positive and Negative Syndrome Scale (PANSS) ,Treatment Emergent Symptoms Scale (TESS) ,WAIS-Ⅲ Digit Span, Number sign,TMT--A,TMT--B and MMSE were used to measure therapeutic efficacy,side effects and cognitive function. Results The PANSS scores decreased significantly at 12 weeks after olanzapine or risperidone treatment (P〈0.05), but no significant difference was found between two groups. The WAIS--III Digit Span, Number sign, the time ofTMT--A and TMT--13 and MMSE scores increased significantly after olanzapine or risperidone treatment. The right number of TMT--A score increased significantly only after olanzapine treatment. There were significant different in WAIS-Ⅲ Digit Span and the right number of TMT--B scores between two groups at the end of 12 weeks. The incidence rate of extrapyramidal symptoms was lower in oIanzapine group than in risperidone group (P 〈 0.05). Conclusions Both olanzapine and risperidone were effective for schizophrenics and can improve cognitive function.
Key words:  Schizophrenia  Cognitive function  Olanzapine  Risperidone

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