喹硫平对帕金森病患者伴精神症状和认知功能的影响

The effects of quetiapine on psychiatric symptoms and cognitive function of patients with Parkinson＇s disease

目的 探讨喹硫平治疗帕金森病患者伴精神症状的临床疗效以及对认知功能的影响.方法 将49例帕金森病伴精神症状患者随机分为两组.研究组27例,口服喹硫平治疗;对照组22例,口服安慰剂治疗.观察8周.于治疗前及治疗第2周、8周末,采用简明精神病量表评定精神症状改善状况;同时测定P300电位内源性成分N2、P3波潜伏期及P3波幅.结果 研究组治疗2周末起简明精神病量表评分较治疗前有显著下降（P＜0.01）,对照组治疗8周末有显著下降（P＜0.05）;研究组治疗各时段均较对照组下降更显著（P＜0.01）.研究组治疗2周、8周末,P300中N2、P3波潜伏期较治疗前显著缩短（P＜0.01）,P3波幅较治疗前显著升高（P＜0.05）;对照组则无显著改变（P＞0.05）.研究组治疗2周、8周末,N2、P3波潜伏期较对照组显著缩短（P＜0.01）,而P3波幅较对照组显著升高（P＜0.05）.结论 喹硫平能有效改善帕金森病的精神症状和认知功能.

Objective To explore the efficacy of quetiapine in the treatment of Parkinson＇s disease （PD） with mental symptoms and its effect on cognitive function. Methods Forty-nine PD patients with psychiatric symptoms were randomly divided into two groups. Research group （n= 27） took orally quetiapine and control group （n=22） did placebo. They were observed for 8 weeks. Improvement status of mental symp toms was assessed with the Brief Psychiatric Rating Scale （BPRS） before treatment and at the end of the 2^nd and 8^th week; endogenous ingredients of P300 potential such as N2 and P3 latency and P3 amplitude were simultaneously determined. Results Compared with pretreatment, the BPRS score lowered more significantly in research group since the end of the 2^nd week （P〈0.01） and in control group at the end of the 8^th week （P〈0.05） ; the BPRS scores in all periods lowered more significantly in research group than in control group （P〈0.01）. At the end of the 2^nd and 8^thweek, N2 and P3 latency shortened more significantly （P〈0.01） and P3 amplitude heightened （P%0.05） compared with pretreatment in research group; there were no significant changes in N2 and P3 latency and P3 amplitude in control group （P〈0.05）. At the end of the 2^nd and 8^th week, N2 and P3 latency shortened more significantly （P〈0.01） and P3 amplitude heightened （P〈0.05） in research than in control group. Conclusion Quetiapine could effectively improve psy chiatric symptoms and cognitive function.