精神分裂症超高危人群、首发患者认知功能与精神病理症状的相关性及帕利哌酮的干预作用

目的：探讨精神分裂症患者各个阶段认知功能的特点及与精神病病理症状的相关性，并研究帕利哌酮的干预作用。方法运用持续操作测验（CPT）和 Stroop 色词测验对满足入组标准的超高危组、首发组及正常组人群进行认知功能评定，并运用阳性与阴性症状量表（PANSS）对各组的精神病性症状进行评估；评估认知功能与精神病症状的相关性。对首发组患者采用帕利哌酮进行治疗，观察治疗前后 CPT、Stroop 色词测验及 PANSS 评分。结果3组 CPT 和 Stroop 色词测验存在显著性差异（ P ﹤0.05）；PANSS 总分与 CPT 存在相关性。首发精神分裂症患者治疗后，CPT 和 Stroop 色词测验得分均明显升高，PANSS 评分显著下降，与治疗前相比，差异有统计学意义（ P ﹤0.05）。结论认知功能缺损可能对精神分裂症发病有一定的预测价值；而疾病的发作可能会进一步加重这一缺损；且精神病性症状愈严重，患者的认知功能下降愈明显。帕利哌酮对首发精神分裂症有良好的治疗作用，能显著改善患者的认知功能和精神病理症状。

Correlation of Cognitive Function and Psychopathological Symptoms in Schizophrenic Super High Risk Population and Intervention Effect of Paliperidone

Objective To investigate the cognitive function characteristics in the various stages of schizophrenic patients and their correlation with the psychopathological symptoms and to research the intervention effect of paliperidone. Methods The continuous performance test （CPT） and Stroop color word test were adopted to assess the cognitive function of the super high risk groups, the first episode group and the normal group meeting the entry criteria, and the positive and negative syndrome scale （PANSS） was adopted to evaluate the psychotic symptoms in each group; then the correlation between the cognitive function and the psychotic symptoms was assessed. The first episode group was treated by paliperidone. The scores of CPT, Stroop color word test and PANSS before and after therapy were observed. Results The statistically significant differences in CPT and the Stroop color word test existed among 3 groups （P 〈 0.05）; the PANSS total score showed the correlation with CPT. After treatment in the first episode schizophrenic patients, the scores of CPT and the Stroop color word test were obviously increased and the PANSS scores were significantly decreased, which showing statistical difference compared with before treatment（ P 〈 0. 05）. Conclusion The cognitive function may exist some predictive value for the schizophrenic onset; while the onset of disease could further aggravate this defect; and the more severe the psychotic symptoms, the more decrease the patient＇s cognitive function. Paliperidone has better curative effect for first episode schizophrenia and could significantly improve the patient＇s cognitive function and psychotic symptoms.