奥氮平对首发精神分裂症认知功能影响的多中心研究

A Multicenter Study of Olanzapine on Congnitive Function in First-episode Schizophrenia

目的探讨奥氮平对首发精神分裂症患者认知功能的影响。方法对100例首发精神分裂症患者进行随机观察。于治疗前,治疗第4周末、8周末、12周末各做一次韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能协调测验、连线测验a和b、威斯康星卡片分类测验(WCST)及言语流利性测验等10项神经心理测查及阳性与阴性症状量表(PANSS)评定。结果两组PANSS总分在治疗后与治疗前比较有显著性差异(P<0.01),研究组有效率98.0%,显效率82.0%;对照组有效率96.0%,显效率78.0%。两组间疗效无显著性差异(P>0.05),氯氮平组副作用比奥氮平组多(P<0.01)。研究组与对照组从8周开始各项神经心理测查有逐渐好转的趋势,与治疗前相比、敲击测验、动作能力测验、手功能协调测验、WCST完成类别数等认知功能均显著改善,且研究组好于对照组(P<0.05)。结论奥氮平治疗对首发精神分裂症患者认知功能有一定的改善作用。

Objective To explore the influence of olanzapine on cognitive function in first-episode schizophrenia.Methods 100 cases of first-episode schizophrenia were conducted a multicenter,randomized clinical trial.The positive and negative scale（PANSS）and 10 neuropsychological tests such as Weschler Adult Intelligence Scale,Weschler Memory Scale,Iorn Nails Tank Test,FInger Tapping Test,Motor Function Test,Coordinated Hand function Test,Connection Test A and B,Wisconsin Card Sort Test（WCST）and Verbal Fluency Test were adopted to assess these subjects at baseline and the end of 4,8,12 weeks.Results The total score of PANSS in both groups showed significant difference after treatment than before（P0.01）.The efficiency rate and markedly effective rate in study group was 98.0% and 82.0% respectively,while control group was 96.0% and 78.0% respectively.There were not significant differences in curative effect between the two groups,but clozapine group had more side effects than olanzapine group（P0.01）.Both groups has gradually improved in neuropsychological tests since 8th weekends.Compared with pre-treatment,neuropsychological tests such as tapping test,motor function test,coordinated hand function test and Wisconsin Card Sort Test were significantly different in both groups,and the study group was better than control groups.（P0.05）.Conclusions Olanzapine can better improve the cognitive function of first-episode schizophrenia.