奥氮平和氯氮平对慢性精神分裂症的认知功能的疗效

Cognitive effects of Olanzapine and Clozapine in chronic schizophrenia

目的:了解奥氮平和氯氮平对慢性精神分裂症患者的认知功能的改善,以及二者对认知功能改善是否相同。方法:78例经典抗精神病药物治疗疗效不显著或不能耐受不良反应的慢性精神分裂症患者随机分配替换为奥氮平及氯氮平治疗,分别在入组前、12周、6月进行PANSS量表评定,以及认知功能的测定,包括言语学习、记忆、注意、执行功能、精神运动。结果:奥氮平组32例和氯氮平组34例完成了6月的治疗,这些患者从基线到6月均显示精神症状显著改善,6月时认知功能显著提高,表现为言语流畅性、言语学习、言语视觉记忆、执行功能方面。但二者之间无显著性差异。结论:奥氮平和氯氮平改善认知功能,且二者的疗效相似。

Objective：To explore whether Olanzapine and Clozapine improve cognitive function in the chronic schizophrenia and the drugs produce similar or different cognitive effects. Methods ：78 chronic schizophrenia patients who had either failed to show sufficient clinical improvement or suffered from side effects with convention antipsychotic were randomly switched to either Olanzapine or Clozapine. All patients completed neuropsychological test designed to index verbal learning, executive function, attention, memory, and psychomotor speed at baseline and after 6 months of treatment. Results： 64 patients completed the 6 months following up who remained on Olanzapine （ n = 32） and Clozapine （ n = 34） for the entire duration with continuous participation. At the end symptoms including positive, negative and cognitive function were significantly improved in the both treatment groups. Cognitive function improved to verbal fluency, verbal learning, verbal and visual memory, executive function. It was no significant difference in the cognitive functions improvement between Olanzapine and Clozapine. Conclusions： Olanzapine and Clozapine indicated similar beneficial effects on the cognitive function showing to executive functions, verbal fluency, verbal learning, and visual memory.