典型与非典型抗精神病药对首发精神分裂症P50感觉门控的作用

目的 比较典型与非典型抗精神病药对P50感觉门控的作用.方法 运用条件-测试刺激模式和刺激序列模式两种方法检测61例首发精神分裂症患者(治疗前后)和36名正常对照的P50听觉诱发电位.患者组依治疗情况分为典型抗精神病药(奋乃静,舒必利)治疗组(简称典型组)和非典型抗精神病药(氯氮平、奥氮平、利培酮和喹硫平)治疗组(简称非典型组),比较两组治疗前后P50感觉门控的差异.结果 治疗前,典型组和非典型组条件-测试刺激模式S2-P50波幅、P50抑制和刺激序列模式高频刺激P50波幅、P50抑制指标均差于对照组,差异均有统计学意义(P<0.05).治疗后,典型组条件-测试刺激模式S2-P50波幅、P50抑制指标虽有改善但与治疗前的差异无统计学意义(P>0.05),但刺激序列模式P50波幅、P50抑制明显改善,与治疗前的差异有统计学意义(P<0.05);非典型组两种模式下P50波幅、P50抑制指标均明显改善,与治疗前的差异均有统计学意义(P<0.05).结论 典型抗精神病药能够改善刺激序列模式P50感觉门控功能,但不能改善条件-测试刺激模式P50感觉门控功能;非典型抗精神病药物能同时改善条件-测试刺激模式和刺激序列模式P50感觉门控功能.

The effects of typical and atypical antipsychotics on P50 sensory gating in first-episode schizophrenics

Objective To compare the effects of typical and atypical antipsychotics treatment on P50 sensory ga-ting in first-episode schizophrenics.Methods Using conditioning-testing stimulus paradigm and stimulus train paradigm to record the P50 auditory evoked potential in 36 normal controls and in 61 first-episode schizophrenics before and after treat-ment.Patients were categorized into two groups:the typical antipsychotic treatment group(typical group)and the atypical antipsychotic treatment group(atypical group).Results Before treatment,both of the typical and atypical groups had low-er levels of S2-P50 amplitude,P50 suppression in conditioning-testing stimulus paradigm and P50 amplitude as well as P50 suppression evoked by high frequency stimuli in stimulus train paradigm in comparison with controls(P<0.05).After treatment,the typical antipsychotic treatment significantly improved the levels of P50 suppression in the stimulus train para-digm but not the levels of S2-P50 amplitude,P50 suppression in the conditioning-testing stimulus paradigm(P<0.05)whereas the atypical antipsychotic treatment improve the levels of P50 amplitude,P50 suppression in both stimulus train paradigm and the conditioning-testing stimulus paradigm(P<0.05). Conclusions The typical antipsychotic treatment can ameliorate the P50 suppression in stimulus train paradigm,but not in the conditioning-testing stimulus paradigm,whereas atypical antipsychotic treatment can ameliorate P50 suppression in both paradigms.