齐拉西酮与碳酸锂对躁狂发作患者疗效及认知功能的影响

目的 探讨齐拉西酮与碳酸锂对躁狂发作患者疗效及对认知功能的影响.方法 将127例躁狂发作患者随机分为两组,分别口服齐拉西酮、碳酸锂治疗,观察12周.于治疗前后采用Bech-Rafaelsen躁狂量表评定临床疗效,成套神经心理测查工具评定认知功能,副反应量表评定不良反应.结果 治疗4周末起两组Bech-Rafaelsen躁狂量表总分均较治疗前显著降低（P＜0.05或0.01）.研究组治疗4周末起、对照组治疗8周末起敲击测验、动作能力测验、手功能协调测验、威斯康星卡片分类测验完成类别数、智能检测等结果显示患者的认知功能均有显著改善（P＜0.05或0.01）,治疗12周末研究组显著优于对照组（P＜0.05或0.01）.研究组副反应量表评分及不良反应发生率显著低于对照组（P＜0.05或0.01）.结论 齐拉西酮与碳酸锂治疗躁狂发作疗效显著且相当,但齐拉西酮对认知功能改善更好,安全性更高.

Efficacy and influence of ziprasidone and lithium carbonate on the cognitive function of patients with manic episode

Objective To explore the efficacy of influence of ziprasidone and lithium carbonate on the cognitive function of patients with manic episode （ME）. Methods A total of 127 ME patients were randomly divided into two groups taking ziprasidone and lithium carbonate respectively for 12 weeks. Before and after treatment efficacies were assessed with the Bech-Rafaelsen Mania Rating Scale （BRMS）, cognitive functions with the complete sets of neuropsychological test tools, and adverse reactions with the Treatment Emergent Symptom Scale （TESS）. Results Since the end of the 4th week the BRMS total scores of both groups lowered more significantly compared with pretreatment （P〈0.05 or 0.01）. Cognitive functions improved significantly by the Finger Tapping Test （FTT）, Motor Function Test （MFT）, Hand Coordination Test （HCT）, Wisconsin Card Sorting Test （WCST） and Wechsler Adult Intelligence Scale （WAIS） since the end of the 4thweek in research group and the 8th in control group （P〈0.05 or 0.01）, the improvements of cognitive functions were more significant in research than control group at the end of the 12^th week （P〈0.05 or 0.01）. The TESS score and incidences of adverse reactions were significantly lower in research than control group （P〈0.05 or 0.01）. Conclusion Ziprasidone and lithium carbonate have an evident and equivalent effect in the treatment of manic episode, the former improves cognitive function better and has higher safety.