帕利哌酮对首发精神分裂症的疗效和认知功能的影响

The Efficacy of Paliperidone Extended-resease Tablets and Its Effect on Cognitive Function in the Treatment of First-outset Schizophrenia

目的探讨帕利哌酮对首发精神分裂症患者的疗效及认知功能的影响。方法对42例首发精神分裂症患者给予帕利哌酮治疗12周,治疗前后进行修订韦氏成人记忆量表(WMS-RC)记忆广度(MS)、威斯康星卡片分类测验(WCST)和阳性与阴性症状量表(PANSS)等评定,并与45例正常人对照。结果研究组治疗12周后,PANSS量表各项指标分值均较治疗前有显著下降(P<0.01)。研究组治疗前后WCST卡片总数(t=3.93,P=0.000)、持续错误(t=2.09,P=0.039)、随机错误(t=3.78,P=0.000)、WMS-RC总分(t=2.37,P=0.020)、记忆商数(t=4.20,P=0.000)均有显著性差异。研究组治疗后在上述WCST、MS数字广度与对照组比较仍有显著性差异(P均<0.05)。治疗前WCST卡片总数、持续错误、随机错误与PANSS总分呈正相关,而WMS-RC总分、记忆商数与阴性症状因子分呈负相关。结论帕利哌酮对精神分裂症有良好的疗效,并能改善认知功能障碍。

Objective To explore the efficacy of paliperidone extended-release tablets and its effect on cognitive function in the treatment of first-outset schizophrenia.Methods A total of 42 patients with schizophrenia（treatment group）were assessed separately with Wechsler Menory Scalerevised China（WMS-RC）,Memory span subtests（MS）of Multiple Memory Assessment Scale,Wisconsin Card Sorting Test（WCST）and Positive and Negative Syndrome Scale（PANSS）before and after treatment by paliperidone for 12 weeks,45 health volunteers were evaluated with WMS-RC、MS and WCST as control group.Results There were significant differences in scores of PANSS（all P0.01）,in number of total WCST tests[（87.24±23.55）vs（67.73±21.95）]（t=3.93,P=0.000）,number of persisting errors[（26.03±16.45）vs（19.72±10.62）]（t=2.09,P=0.039）,number of random errors [（36.45±15.70）vs（24.32±13.65）]（t=3.78,P=0.000）,total points of WMS-RC [（98.48±19.16）VS（108.15±18.23）]（t=2.37,P=0.020）,MQ[（87.46±19.63）vs（106.31±21.43）]（t=4.20,P=0.000） between before and after treatment in treatment group.There were also significant differences in these items of WCST and digit span of MS between the treatment group and the control group after treatment for 12 weeks（P0.05）.Number of total WCST tests,number of persisting errors and number of random errors were all positively related to the score of PANSS before treatment,but total points of WMS-RC and MQ were negatively related to the score of negative subscale.Conclusion Paliperidone extended-release tablets in patients with schizophrenia is significantly effective,and also improves thecognitive fuacion disorder in schizophrenia.