碳酸锂、丙戊酸钠及奎硫平对双相障碍患者认知功能的影响

摘要

Objective:To investigate the effects of lithium carbonate,valproate and quetiapine on cogni tive function of patients with bipolar disorder. Method: A total of 110 bipolar I disorder patients in stable state were recruited and randomly assigned to 4 groups according to the treatment of drugs :26 patients with lithi um carbonate,24 patients with valproate,27 patients with lithium carbonate + quetiapine and 33 patients with valproate + quetiapine. Digital symbol, trail making test, digit span, visual reproduction, verbal fluency test, Wisconsin card sorting test ( WCST) and tower of Hanoi test were used to evaluate cognitive function, then the differences between groups were compared. Results: Spearman correlation analysis showed that course of dis ease and all the indicators of cognitive function were not significantly related ( P > 0. 05 ) . The single factor anal ysis of variance found that only the difference of tower of Hanoi planning time was statistically significant be tween the groups ( F = 3. 5 ,P < 0. 05 ) . LSD test showed that tower of Hanoi planning time of lithium carbonate group were less than the other groups,and the difference was statistically significant (P<0.05). Conclusion: Lithium carbonate may impaire some executive function in patients of stable bipolar disorder.%目的:探讨碳酸锂,丙戊酸钠和奎硫平对双相障碍患者认知功能的影响.方法:110例稳定期双相障碍Ⅰ型患者分成4组,分别是碳酸锂组26例,丙戊酸钠组24例,碳酸锂+奎硫平组27例和丙戊酸钠+奎硫平组33例.采用数字符号,连线测验,数字广度,视觉再生,言语流畅性测验,威斯康星卡片分类测验(WCST)和汉诺塔检测认知功能,比较组间认知功能的差异.结果:Spearman相关分析显示,病程与所有认知功能指标均无显著相关(P均＞0.05).方差分析显示,汉诺塔计划时间组间差异有统计学意义(F=3.5,P ＜0.05).LSD检验表明,碳酸锂组的汉诺塔计划时间成绩分别比丙戊酸钠组,碳酸锂+奎硫平组和丙戊酸钠+奎硫平组差,差异有统计学意义(P＜0.05).结论:碳酸锂可能对稳定期双相障碍患者的某些执行功能有损害.