碳酸锂、丙戊酸钠及奎硫平对双相障碍患者认知功能的影响

The effects of lithium carbonate,valproate and quetiapine on cognitive function of patients with bipolar disorder

目的:探讨碳酸锂,丙戊酸钠和奎硫平对双相障碍患者认知功能的影响。方法:110例稳定期双相障碍I型患者分成4组,分别是碳酸锂组26例,丙戊酸钠组24例,碳酸锂+奎硫平组27例和丙戊酸钠+奎硫平组33例。采用数字符号,连线测验,数字广度,视觉再生,言语流畅性测验,威斯康星卡片分类测验(WCST)和汉诺塔检测认知功能,比较组间认知功能的差异。结果:Spearman相关分析显示,病程与所有认知功能指标均无显著相关(P均>0.05)。方差分析显示,汉诺塔计划时间组间差异有统计学意义(F=3.5,P<0.05)。LSD检验表明,碳酸锂组的汉诺塔计划时间成绩分别比丙戊酸钠组,碳酸锂+奎硫平组和丙戊酸钠+奎硫平组差,差异有统计学意义(P<0.05)。结论:碳酸锂可能对稳定期双相障碍患者的某些执行功能有损害。

Objective ：To investigate the effects of lithium carbonate, valproate and quetiapine on cognitive function of patients with bipolar disorder. Method ： A total of 110 bipolar I disorder patients in stable state were recruited and randomly assigned to 4 groups according to the treatment of drugs ：26 patients with lithium carbonate,24 patients with valproate,27 patients with lithium carbonate ＋ quetiapine and 33 patients with valproate ＋ quetiapine. Digital symbol, trail making test, digit span, visual reproduction, verbal fluency test, Wisconsin card sorting test （WCST） and tower of Hanoi test were used to evaluate cognitive function,then the differences between groups were compared. Results：Spearman correlation analysis showed that course of disease and all the indicators of cognitive function were not significantly related （ P 〉 0.05 ）. The single factor analysis of variance found that only the difference of tower of Hanoi planning time was statistically significant between the groups （ F = 3.5 ,P 〈 0.05 ）. LSD test showed that tower of Hanoi planning time of lithium carbonate group were less than the other groups,and the difference was statistically significant （P 〈 0.05）. Conclusion： Lithium carbonate may impaire some executive function in patients of stable bipolar disorder.