喹硫平与氯丙嗪对精神分裂症认知功能影响的对照研究

摘要

目的 比较喹硫平与氯丙嗪对精神分裂症认知功能的影响.方法 应用随机对照的方法,将80例符合条件的精神分裂症患者随机分为两组,喹硫平组40例,氯丙嗪组40例,进行8周的系统治疗.在治疗前后进行MCCB认知评定与事件相关电位P300的测定.结果 喹硫平组MCCB中的语义流畅性(11.45±6.50)、连线(0.12±0.04)、符号编码(23.50 ± 10.52)、数字序列(11.02±5.04)、空间广度(9.31±4.21)、持续操作(110.20±28.30)、情绪管理(6.42±1.55)分数低于氯丙嗪组(16.88±6.55,0.23±0.02,32.60±10.14,15.32±5.32,12.55 ± 4.38,174.20±29.50,7.68±1.55),两者差异显著(P＜0.05)；喹硫平组P300的波幅显著高于氯丙嗪组,而喹硫平组潜伏期显著短于氯丙嗪组(P＜0.05).结论 喹硫平较氯丙嗪能显著改善精神分裂症患者的认知功能,其具体的机制尚需进一步探讨.%Objective To compare the effect of quetiapine and chlorpromazine on cognitive function in schizophrenic patients. Methods A total of 80 schizophrenic patients were randomly divided into quetiapine group treated with quetiapine and chlorpromazine group treated with chlorpromazine for 8 weeks. All patients were assessed with MCCB and ERP-P300 at the baseline and at the end of the treatment. Results At the end of the 8-week treatment, scores of fluent of meaning (11. 45 ± 6. 50 ) , trail making test (0. 12 ± 0.04 ) , coding (23. 50 ± 0. 52) , sequence of numbers (11. 02 + 5.04), spatial span (9.31 ±4.21), continuous performance test (110. 20 ± 28. 30) , emotion manage (6.42 ± 1. 55) in MCCB in quetiapine group were significantly lower than those in chlorpromazine group ( 16. 88 ±6. 55, 0. 23 ±0.02, 32.60 ±10.14, 15.32±5.32, 12.55 ±4.38, 174.20 ±29.50, 7. 68 ±1.55) (P<0.05). The amplitude of ERP - P300 in quetiapine group were significantly higher than that in chlorpromazine group (P <0. 05) , while the latency of ERP-P300 in quetiapine group were significantly shorter than that in chlorpromazine group ( P < 0. 05 ) . Conclusion Quetiapine improves cognitive function of schizophrenia more effectively than chlorpromazine. But the precise mechanism need further studies.