奥氮平与利培酮治疗老年精神分裂症患者疗效及执行功能比较

Efficacy and executive function of olanzapine and risperidone in the treatment of elderly patients with schizophrenia

目的:比较奥氮平与利培酮治疗老年精神分裂症的疗效及对执行功能的影响。方法:84例老年精神分裂症患者随机分为奥氮平组(43例)和利培酮组(41例),于治疗前及治疗后第8周末采用阳性与阴性症状量表(PANSS)和威斯康星卡片分类测验(WCST)评定疗效和执行功能,分别比较每组治疗前后及两组间的结果。结果:治疗后奥氮平组的有效率及显效率分别为90.6%和67.4%,利培酮组的有效率及显效率分别为92.6%和68.3%,两者差异无统计学意义(P>0.05)。治疗后奥氮平组的阴性症状分低于利培酮组(P<0.01)。利培酮组WCST的完成分类数低于奥氮平组,持续性错误数和总错误数高于利培酮组(P<0.01)。结论:奥氮平和利培酮均能有效改善老年精神分裂症的症状和执行功能,但奥氮平对阴性症状和执行功能的改善效果更好。

AIM： To explore the difference on efficacy and executive function between olanzap- ine and risperidone in treatment of elderly pa- tients with schizophrenia. METHODS： 84 elder- ly patients with schizophrenia were randomly di- vided into olanzapine group （43 cases） and ris- peridon group （41 cases） treated for 8 weeks. The efficacy was assessed with the positive and negative symptoms scale （PANSS） and the exec- utive function was evaluated with Wisconsin Card Sorting Test （WCST） in baseline and after 8 weeks of treatment. RESULTS：After 8 weeks of treatment, the efficacy rate of olanzapine was 90.6% , in which 67.4% was improved marked- ly. The efficacy rate of risperidon was 92.6%, in which 68.3% were improved markedly. There were no differences between two groups （P〉0.01）. The score of negative symptom of olanzapine group was significantly lower than that of risperidon group（P〈0. 05）. The score of categories control in risperidon group was signif- icantly lower than that in olanzapine group, per- sistent errors and response error were higher than that in olanzapine group（P〈0. 01）. CON- CLUSION. Both olanzapine and risperidon can improve the symptom and executive function of elderly patients with schizophrenia. Olanzapine is better than risperidon in improving negative symptom and executive function.