阿立派唑对精神分裂症患者认知功能的影响

Effects of aripiprazole on cognitive function in schizophrenia

目的探讨新型抗精神病药阿立派唑对精神分裂症患者认知功能的疗效。方法对40例住院精神分裂症患者治疗前后进行威斯康星卡片分类试验、持续操作试验、倒行掩敝试验、阳性与阴性症状量表(PANSS)测验,并与45例正常人对照。结果治疗组在治疗前后威斯康星总测验次数[(82.5±15.1)次,(70.3±10.2)次]、持续错误数[(31.1±10.2)次,(22.3±5.90)次]、随机错误数[(27.4±11.0)次,(23.4±7.60)次],持续操作预警错误数[(5.48±2.79)次,(3.65±2.98)次],倒行掩敝总对数[(33.13±6.09)次,(37.4±4.14)次]均差异有显著性(P<0.05);但治疗组上述指标在疗前、治疗8周时与正常对照组相比,治疗后持续操作的预警错误数减少到与正常组[(3.50±3.09)次]无差异(P>0.05),其他指标仍有差异(P<0.05)。治疗前WCST总测验数、持续错误数、随机错误数与PANSS总分成正相关;随机错误数与一般精神病成正相关(r=0.326),持续操作测验的预警错误数与之成负相关(r=-0.384)。结论阿立派唑对精神分裂症患者的认知障碍具有一定的改善作用。

Objective To study the therapeutic effects of aripiprazole on cognitive function in patients with schizophrenia. Methods 40 inpatients with schizophrenia （treatment group） were measured by WCST, persisting operation test, inverse masking test and PANSS scale before and after aripiprazole treatment. As control group, 45 health volunteers with age, sex and education years matched were recruited. Results There were sig- nificant differences in number of total WCST tests （82.5 ±15. 1, 70.3± 10.2）, number of persisting errors （31.1 ±10.2,22.3 ± 5.90） , number of random errors （27.4 ± 11.0, 23.4 ± 7.60）, number of errors of precaution in persisting operation test （5.48 ± 2.79,3.65 ± 2.98） and number of total inverse masking （33.13 ± 6.09, 37.4 ±4.14） between before and after treatment in treatment group. There were also significant differences in these measures between the treatment group before accepting treatment or after accepting 8 weeks of treatment and the control group, with exception of number of errors of precaution in persisting operation test, reduced to the levels of the control group, in treatment group receiving 8 weeks of treatment. Before treatment, number of total WCST tests, number of persisting errors and number of random errors were all positively related to total scores of PANSS ; number of random errors was positively （ r= 0. 326） but number of errors of precaution in persisting operation test was negatively related to the factor of common psychopathology in PANSS（ r= - 0. 384）. However, there was no relationship of WCST test, persisting operation test and inverse masking test to PANSS scores. Conclusion Aripiprazole can, to some degree, improve the cognitive disorder in schizophrenia.