齐拉西酮联合改良电抽搐治疗对精神分裂症患者认知功能的影响

Effects of ziprasidone combined with MECT on cognitive function of schizophrenia patient

目的探讨齐拉西酮联合改良电抽搐治疗对精神分裂症患者认知功能的影响。方法将54例精神分裂症患者随机分为研究组和对照组各27例，两组均口服齐拉西酮治疗，研究组在此基础上联合改良电抽搐治疗，观察5周。于治疗前及治疗5周末采用连线测验、数字符号转换测验、言语流畅性测验、数字广度测验评定认知功能，采用阳性与阴性症状量表评定临床疗效。结果治疗5周末两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（P〈0．01），同期两组间评分比较差异均无显著性（P〉0．05）。治疗5周末两组连线测验A、连线测验B测试所耗时间及研究组数字符号转换测验评分均较治疗前显著下降（P〈0．05或0．01）；治疗前两组各项测验结果比较差异无显著性（P〉0．05），治疗后研究组数字符号转换测验评分显著低于对照组（P〈0．01），其他测验结果两组比较差异均无显著性（P〉0．05）。结论齐拉西酮联合改良电抽搐治疗精神分裂症疗效显著，且与单用齐拉西酮相当；对患者的精神运动速度和言语功能无明显影响，对注意力有一定损害，对工作记忆有显著改善作用。

Objective To explore the influences of ziprasidone plus modified electroconvulsive therapy （MECT） on cognitive function of schizophrenia patient. Methods Fifty-four patients with schizophrenia were randomly assigned to two groups of 27 ones each, both groups received ziprasidone treatment, and research group was plus MECT for 5 weeks. Cognitive functions were assessed with the Trail Making Test （TMT）, Symbol Digit Modalities Test （SDMT）, Verbal Fluency Test （VFT） and Digit Span Test （DST） and efficacies with the Positive and Negative Syndrome Scale （PANSS） at baseline and the end of the 5^th week. Results At the end of the 5^th week, the total and each factor score of the PANSS of both groups lowered more significantly compared with pretreatment （P〈0.01）, there were no significant differences in contemporary group comparisons （P〈0.05）. At the end of the 5^th week, time consumptions of TMT-A and -B and SDMT score of both groups lowered more significantly compared with pretreatment （P〈0.05 or 0.01） ; there were no significant differences in each test result before treatment （P〈0.05）, after treatment SDMT score was significantly lower in research than in control group （P〈0.01） and there were no significant group differences in other tests （P〈0.05）. Conclusion Ziprasidone plus MECT has an evident effect equivalent to ziprasidone in the treatment of schizophrenia; that has no notable effects on psychomotor speed and speech function, impairs attention certainly and improves working memory notably.