3种抗精神病药对精神分裂症认知功能的影响

目的:探讨阿立哌唑、利培酮和氯丙嗪对首发精神分裂症患者认知功能的影响。方法:56例首发精神分裂症患者分为阿立哌唑组(n=18)、利培酮组(n=24)和氯丙嗪组(n=14),在治疗前和治疗6周进行阳性与阴性症状量表(PANSS)评分,威斯康星卡片分类测验(WCST)、连线测验(A和B)、韦氏成人智力量表(WAIS)中的数字符号和数字广度(顺、逆)测验等神经心理测验。结果:治疗6周后,3组PANSS评分均明显下降,3组之间差异无显著性。阿立哌唑组和利培酮组各项认知功能指标均有不同程度的改善,而氯丙嗪组只有2项(WCST中持续反应数和数字广度测验)较治疗前显著好转。连线测验B阿立哌唑组显著优于利培酮组,其余各指标两组间差异无显著性。阿立哌唑组除WCST中持续反应数、完成分类数和数字广度测验外,其余各指标均显著优于氯丙嗪组;利培酮组除WCST中持续反应数外,其余各指标均显著优于氯丙嗪组。结论:阿立哌唑和利培酮对首发精神分裂症患者认知功能的改善作用相当,均显著优于氯丙嗪。

Influence of three antipsychotics on cognitive function in schizophrenia

Objective:To study the effects of aripiprazole,risperidone and chlorpromazine on cognitive function in patients with schizophrenia.Method:56 first-episode patients with schizophrenia were divided into aripiprazole group(n=18),risperidone group(n=24)and chlorpromazine group(n=14).The positive and negative syndrome scale(PANSS)were evaluated before and after 6 weeks treatment.All patients were tested with neuropsychological tests,including Wisconsion card sorting test(WCST),trail making test(A and B)and digit symbol test and digit span test(clockwise and anticlockwise)in Wechsler adult intelligence scale(WAIS)before and after 6 weeks treatment.Results:The total scores of PANSS were significantly lower after 6 weeks treatment,but no significant difference was found among the three groups.After 6 weeks treatment,all indices of cognitive function improved in patients of aripiprazole group and risperidone group,while only two indices,persistent responses(PR)and digit span test in WCST,improved significantly in patients of chlorpromazine group.Compared to patients in risperidone group,patients in aripiprazole group conducted significantly better in trail making test B.The rest indices didn't show difference between the two groups.Except indices of PR,categories control(CC)and digit span test in WCST,the other indices in aripiprazole group were significantly better than that in chlorpromazine group.Except index of PR in WCST,the other indices in risperidone group were significantly better than that in chlorpromazine group.Conclusion:The improvement on cognitive function of aripiprazole is equal to risperidone,both of them significantly better than chlorpromazine.