氯氮平与氯丙嗪对维持治疗期老年精神分裂症患者认知功能的影响分析

摘要

目的：探究氯氮平与氯丙嗪对维持治疗期老年精神分裂症患者认知功能的影响。方法选择2013年5月至2015年1月于本院诊治的60例老年精神分裂症患者为研究对象，采用随机双盲法将入选患者分为试验组和对照组，每组各30例。试验组患者给予氯氮平治疗，对照组患者给予氯丙嗪治疗。分别采用阳性和阴性症状量表（positive and negative syndrome scale，PANSS）、中国修订版韦氏记忆量表（Chinese Wechsler memory scale-revised，WMS-RC）以及中国成人智力量表（Chinese intelligence scale of adults，CISA）评价患者治疗效果。结果治疗后，试验组患者WMS-RC评分中认知总分、心智、图形记忆、再认各项评分均明显高于治疗前（P＜0.05），且均明显高于对照组（P＜0.05）；治疗后两组患者联想和理解记忆评分均明显低于治疗前（P＜0.05），但组间比较差异均无显著性（P＞0.05）。治疗后两组患者CISA评分均高于治疗前（P＜0.05），且试验组患者CISA评分高于对照组（P＜0.05）。试验组患者总不良反应发生率为10.0%（3/30），显著低于对照组[26.7%（8/30）]（P＜0.05）。结论氯氮平治疗老年精神分裂症效果显著，不良反应少，在一定程度上改善了患者的认知功能障碍，提高了患者的生活质量和远期疗效。%Objective To investigate the effect of clozapine and chlorpromazine on the cognitive function of elderly patients with schizophrenia during maintenance treatment. Method 60 cases of elderly patients with schizophrenia treated in our hospital from May 2013 to January 2015 were randomly divided into experimental group and control group, 30 patients in each group. Patients in experimental group were treated with clozapine, and control group patients were received chlorpromazine treatment. The efficacy were evaluated before and after treatment by positive and negative syndrome scale (PANSS), Chinese Wechsler memory scale-revised (WMS-RC) and Chinese intelligence scale of adults (CISA). Result After treatment, experimental group patients with WMS-RC score in cognitive scores, mental, graphic memory, recognition scores were significantly higher than those before treatment (P<0.05), and were significantly higher than control group (P<0.05);after treatment two groups patients with association and memory scores were significantly lower than those before treatment (P < 0.05), but there was no significant difference between the two groups (P > 0.05). After treatment, the CISA scores of the two groups were higher than those before treatment (P < 0.05), and the CISA score of experimental group was higher than control group (P < 0.05). Experimental group of patients with adverse reaction rate was 10%(3/30), significantly lower than control group [26.7%(8/30)] (P<0.05). Conclusion Clozapine is effective in the treatment of schizophrenia in elderly patients, with fewer adverse reactions, which can improve the cognitive function of patients, quality of life and long-term efficacy.