喹硫平利培酮阿立哌唑对精神分裂症患者认知功能的影响

摘要

Objective To explore the efficacy of quetiapine ,risperidone and aripiprazole in schizophrenia patients and their effects on cognitive functions .Methods A total of 154 schizophrenics were assigned to three groups taking orally quetiapine (n=65) ,risperidone (n=47) or aripiprazole (n=42) for 24 weeks . Efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS) and cognitive functions with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) .Results In the 24th week the PANSS scores of 3 groups improved more significantly ,so did that in quetiapine than risperi‐done and aripiprazole group (P<0 .05);there were significant differences in 9 factor scores of the RBANS among 3 groups (P<0 .05 or 0 .01) ,8 factor scores improved more significantly in aripiprazole than other 2 groups .There were significant differences in the improvement of cognitive function among patients with different gender and educational levels (P<0 .05) .The improvement of cognitive function was better in schizophrenia patients combined with somato‐diseases than single schizophrenia ones (P<0 .05) .Conclu‐sion Quetiapine ,risperidone and aripiprazole all could significantly improve various kinds of mental symp‐toms and cognitive function of schizophrenia patients ;the improvement of cognitive function is better in schizophrenia patients combined with somato‐diseases than single schizophrenia ones ,gender and educa‐tional levels are important factors influencing cognitive function changes .%目的：探讨喹硫平、利培酮和阿立哌唑对精神分裂症患者临床疗效及认知功能的影响。方法将154例精神分裂症患者分为3组，分别口服喹硫平（65例）、利培酮（47例）和阿立哌唑（42例）治疗，观察24周。采用阳性与阴性症状量表评定临床疗效，重复性成套神经心理状态测验评定认知功能。结果治疗24周末3组阳性与阴性症状量表评分均有显著改善，但喹硫平组改善阳性症状显著优于利培酮组和阿立哌唑组（P＜0．05）；3组重复性成套神经心理状态测验的9个因子分比较差异有显著性（ P＜0．05或0．01），阿立哌唑组对8个因子分的改善优于其他2组。不同性别、文化程度患者的认知功能改善有显著性差异（P＜0．05）。合并躯体疾病患者认知功能的改善显著差于单纯精神分裂症患者（P＜0．05）。结论喹硫平、利培酮和阿立哌唑均能显著改善精神分裂症患者的各种精神症状及认知功能；合并躯体疾病的患者认知功能改善差于单纯精神分裂症患者，性别、文化程度是影响认知功能改变的重要因素。