齐拉西酮与阿立哌唑对首发精神分裂症患者认知功能的影响

The influences of ziprasidone and aripiprazole on cognitive function in first-episode schizophrenia

目的 探讨齐拉西酮与阿立哌唑对首发精神分裂症患者的临床疗效及认知功能的影响.方法 将62例首发精神分裂症患者随机分为齐拉西酮组30例和阿立哌唑组32例,分别口服齐拉西酮与阿立哌唑治疗,观察8周.于治疗前及治疗4周、8周末采用阳性与阴性症状量表评定临床疗效;于治疗前及治疗8周末,采用韦氏记忆量表评定记忆功能.抽取同期健康志愿职工30名设为对照组,于入组时采用韦氏记忆量表评定记忆功能.结果 治疗后两组患者阳性与阴性症状量表总分及各因子分减分率均呈持续性升高,治疗8周末均显著高于治疗4周末（P＜0.01）;同期两组间比较差异均无显著性（P＞0.05）.治疗前两组患者韦氏记忆量表测评1→100、100→1、积累、再认、联想、理解、背数及记忆商数因子分均显著低于对照组（P＜0.05或0.01）;治疗8周末,再认、联想、理解、背数及记忆商数因子分均较治疗前有显著提高（P＜0.05或0.01）,但1→100、100→1、积累因子分仍显著低于对照组（P＜0.05或0.01）.结论 精神分裂症患者存在明显的认知功能缺陷,齐拉西酮与阿立哌唑在改善精神分裂症患者阳性症状和阴性症状的同时,还能显著改善记忆状况等认知功能,且两药总体效果相当,值得临床推广应用.

Objective To explore the efficacy and influences on cognitive function of ziprasidone and aripi- prazole in the treatment of first-episode schizophrenics. Methods Sixty-two first-episode schizophrenics were randomly divided into ziprasidone group （n=30） taking orally ziprasidone and aripiprazole group （n= 32） doing aripiprazole for 8 weeks. Efficaeies were assessed with the Positive and Negative Syndrome （PANSS） before treatment and at the end of the 4a~ and 8~h week; memory function was assessed with the Wechsler Memory Scale （WMS） before treatment and at the end of the 8th week. Thirty healthy volunteer employees were assigned to control group, their memory function assessed with WMS at enrolment. Re- sults After treatment, the decrease rate of total and each factor score of the PANSS of both groups con tinuously heightened and were significantly higher at the end of the 8＇h week than the 4＇h（p^0. 01） ; there were no significant differences in contemporaneous comparisons （P〈0.05）. Before treatment such factor score as 1→100, 100→1, accumulation, recognition, association, comprehension, digit span and memory quotient were significantly lower in both ziprasidone and aripiprazole group than control group （P〈0.05 or 0.01） ; at the end of the 8th week recognition, association, comprehension, digit span and memory quotient score of both ziprasidone and aripiprazole groups significantly higher （P〈0.05 or 0.01）,but 1→100, 100 →1 and accumulation lower （P〈0. 05 or 0.01） compared with control group. Conclusion Schizophrenics have evident cognitive function defects, both ziprasidone and aripiprazole can improve cognitive function such as memory status at the same time of improving positive and negative symptoms, have equivalent total efficacy, and deserve clinieal generalization and application.