阿立哌唑合并氯氮平对难治性精神分裂症疗效和认知功能影响的研究

A self-controlled study of aripiprazole combined with clozapine on efficacy and cognitive function in patients with treatment-resistant schizophrenia

目的探讨阿立哌唑合并氯氮平对难治性精神分裂症疗效及认知功能的影响。方法对45例原服用氯氮平治疗的难治性精神分裂症患者合并阿立哌唑(10～30)mg/d治疗12周,同时2周内将氯氮平减量至维持剂量后不再变化,并于合并治疗前及治疗后12周末用阳性与阴性症状量表(PANSS)、副反应量表(TESS)评定疗效和副反应,以威斯康星卡片(WCST)和连续作业测验(CPT)评定患者的认知功能。结果合并阿立哌唑治疗后12周末PANSS总分和TESS评分较合并前有明显差异(P<0.01,P<0.05),各项认知功能指标均有不同程度改善。结论阿立哌唑合并氯氮平对难治性精神分裂症阴性症状及认知功能的改善明显,副反应减少。

Objective To explore the effects of aripiprazole combined with clozapine on efficacy and cognitive function for patients with treatment-resistant schizophrenia. Methods A total of 45 treatment-resistant schizophrenic patients treated with clozapine were combined with aripiprazole （10-30mg/d） for 12 weeks, at the same time clozapine was lowered to maintenance does within 2 weeks. The efficacy and side effects were assessed with Positive and Negative Symptom Scale （PANSS） and Treatment Emergent Symptoms Scale （TESS）, the cognitive function were measured with Wisconsion Card Sorting Test （WCST） and Continuous Performance Test （CPT） at baseline and at the 12th weekend of the treatment. Results At the end of the treatment, scores of PANSS and TESS decreased significantly, and each parameters of cognitive function was significantly improved when compared with those at baseline. Conclusion Aripiprazole combined with clozapine can effectively improve the negative symptoms and cognitive functions in patients with treatment-resistant schizophrenia with few side effects.