利培酮合并赛来昔布治疗对精神分裂症首次发病患者认知功能的影响

目的 探讨利培酮合并赛来昔布对精神分裂症首发患者认知功能的影响.方法 符合美国精神障碍诊断与统计手册第4版诊断标准的精神分裂症首次发病(以下简称首发)住院患者90例,随机分到利培酮+赛来昔布组(研究组,46例)或利培酮+空白剂组(对照组,44例),观察治疗时间均为12周.认知功能评定使用阳性和阴性症状量表、汉密尔顿抑郁量表、威斯康星卡片分类(WCST)、重复性神经心理测查系统(RBANS).结果 治疗第12周末,研究组PANSS总分及分量表分低于对照组(P均＜0.05);研究组HAMD评分低于对照组;两组患者RBANS测验总分及部分分量表评分均较基线明显提高,差异均有统计学意义(P均＜0.05);WCST部分因子分均较基线有明显改善,差异均有统计学意义(P均＜0.05);两组间各量表评分的差异均无统计学意义(P均＞0.05).研究组男性患者的延时记忆量表分明显高于女性患者,差异有统计学意义(F=4.8;υ=1.0,38;P=0.03),且临床症状的改善与认知功能的提高存在显著相关性(P＜0.05).结论 利培酮具有改善首发精神分裂症患者认知功能的作用;赛来昔布对男性患者的延时记忆有改善作用.

Effects of adjunctive celecoxib treatment with risperidone on the cognitive function in first-episode schizophrenia patients

Objective To evaluate the effects of celecoxib added to risperidone on the cognitive function in the first-episode patients with schizophrenia.Methods Ninety inpatients with first-episode schizophrenia (DSM-IV criteria) were enrolled and assigned randomly into risperidone plus celecoxib group (46 cases) and risperidone plus placebo group (44 cases).The dosage of risperidone,starting from 2 mg/ d was adjusted according to the clinical efficacy and side-effects.The dosage of celecoxib was 200 mg/d for the first week,and maintained at 400 mg/d until the end of 12-week study.The cognitive function was rated with the Wisconsin Cards Sort Test (WCST) and Repeatable Battery for the Assessmental of Neurepsychological Status(RBANS) both at baseline and after 12 week.The psychiatric symptoms were rated with the Positive and Negative Syndrome Scale and Hamilton Depression Scale at baseline,4-,8- and 12-week treatment.Results The RBANS total score,immediate memory subscore,attention subscore and delayed memory subscore were markedly increased after treatment in celecoxib group ( all P ＜ 0.05 ),and so was in placebo group but not of the immediate memory subscore.The delayed memory subscore was significantly higher in males than females in celecoxib group (P ＜0.05 ).The subscores of categories completed,replies correct,replies error (Re) and replies of the first categories (Rf) of WCST were markedly improved after treatment in celecoxib group ( P ＜ 0.05 ),and so were the subscores of Re and Rf of WCST in placebo group ( P ＜ 0.05 ),but no significant difference in any scale scores between the two groups ( all P ＞ 0.05 ).The improvements of psychiatric symptoms were significantly correlated to the increase of cognitive function in celecoxib group ( P ＜ 0.05 ),but not in placebo group.Conclusion The results suggest risperidone could improve cognitive function in patients with first-episode schizophrenia,and adjunctive celecoxib therapy promote delayed memory in males.