利培酮与氯氮平治疗精神分裂症的疗效及对P300的影响

Risperidone and Clozapine:Comparison of Therapy Effect on Schizophrenia

目的探讨利培酮治疗精神分裂症患者的疗效,并与氯氮平作比较,同时探讨二者对P300的影响。方法 64例精神分裂症患者随机分为治疗组和对照组各32例,治疗组采用利培酮:初始剂量1mg/d,2周内增加剂量至(4～6)mg/d。对照组采用氯氮平:(200～450)mg/d,分两次给药。采用PANSS于治疗前、后评定疗效,观察比较两组的P300潜伏期、P300波幅变化情况。结果治疗组的有效率为87.5%,对照组的有效率为81.2%,差异无显著性(P>0.05)。治疗前两组PANSS评分比较,差异无显著性(P>0.05)。治疗后,治疗组和对照组的PANSS均明显低于治疗前,差异有显著性(P<0.01),但与对照组比较,差异无显著性(P>0.05)。治疗前两组P300潜伏期、P300波幅分别比较,差异均无显著性(P>0.05)。治疗后,治疗组P300潜伏期与治疗前比较明显降低,且降低幅度较对照组明显;治疗组P300波幅与治疗前比较明显增高,且增高幅度较对照组明显。结论利培酮能改善阴性症状和认知功能,改善认知功能的总体效应优于氯氮平;利培酮改善认知功能效果好,有利于患者回归社会,恢复正常的工作与生活。

Objective To explore the therapy effect of risperidone on schizophrenia and compare it with clozapine and the influence of the two on P300. Methods Sixty-four cases of schizophrenia were randomly divided into treatment group and control group with 32 in each. The treatment group was given risperidone, with its initial dose of 1 mg/day for 2 weeks,then increasing to the dose （4-6） rag/day. The control group was given clozapine （200-450）mg/day,with the dose administered twice per day. PANSS was used to evaluate the effects before and after treatment,and P300 latency （ms） and P300 amplitude （uv） changes in the two groups were observed and compared. Results The effective rate of the treatment group was 87.5% and that of the control group was 81.2%,with no significant difference（P〉0.05）. There was no significant difference in the PANSS scores between the two groups before treatment（P〉0.05）, and the PANSS scores of both groups were significantly lower after treatment, with a significant difference in the two groups between pre-treatment and post-treatment（P〈0.01）,with no significant difference between the two groups（P〉0.05）. There was no significant difference in the P300 latency and the P300 amplitude between the two groups before treatment（P〉0.05）. After treatment, the P300 latency of the treatment group was significantly decreased compared with pre-treatment, much lower than control group. After treatment,the P300 amplitude of the treatment group was significantly increased compared with pre-treatment, much higher than the control group. Conclusion Risperidone can improve negative symptoms and cognitive function and shows more effective in the improvement of the cognitive function compared with clozapine.