不同类型抗精神病药物对精神分裂症患儿血清同型半胱氨酸水平及认知功能的影响

Effect of Different Types of Antipsychotics on Serum Homocysteine Level and Cognitive Function in Children with Schizophrenia

目的探讨抗精神病药物对精神分裂症患儿血清同型半胱氨酸(Hcy)水平及认知功能的影响。方法将96例首发精神分裂症患儿分为非经典抗精神病药物治疗组(研究组)和经典抗精神病药物治疗组(病例对照组),分别测定治疗前后2组患儿血清Hcy水平和事件相关电位(ERP),并将检测结果与50例健康儿童(健康对照组)进行比较。结果与健康对照组比较,治疗前研究组和病例对照组患儿血清Hcy水平明显增高,ERP测定中N2波潜伏期(PL)、P3PL明显延长,P3波幅(amp)明显降低,差异均有统计学意义(Pa<0.01);研究组和病例对照组治疗前血清Hcy水平及ERP各指标比较差异无统计学意义。与治疗前比较,治疗后研究组N2PL、P3PL缩短,P3 amp增高,血清Hcy水平降低,差异均有统计学意义(Pa<0.01);而病例对照组各指标比较差异均无统计学意义。治疗后与病例对照组比较,研究组N2PL、P3PL缩短,P3 amp增高,血清Hcy水平降低,差异均有统计学意义(Pa<0.01)。结论儿童精神分裂症患者存在一定程度的高Hcy血症和认知功能损害,非经典抗精神病药物治疗可明显改善精神分裂症患儿的Hcy水平和认知功能。

Objective To discuss the effect of antipsychotics on serum homocysteine （Hcy） level and cognitive function in children with schizophrenia. Methods Ninety - six children with primary schizophrenia were divided into typical antipsychotics treatment group and atypi- cal antipsychotics treatment group,and the serum Hcy level and event- related potentials （ERP） of the patients before and after treatment in the 2 groups were detected, after that the results were compared with those in healthy control group（50 healthy cases）. Results There was no statistical difference in serum Hcy level and each index of ERP before treatment between the 2 treatment groups,but compared with those in healthy control group, the serum Hcy level was increased, the N2 period latency （PL） and P3PL in ERP were prolonged, and the P3 amplitude （amp） were decreased,and there were significant differences （P~ 〈0.01 ）. Compared with before treatment,the N2PL and P3PL in ERP after treatment in atypical antipsychotics treatment group were decreased, while the P3 amp was increased, and the serum Hcy level was also de- creased, and there were significant differences （P 〈 0.01 ） , but there was no statistical difference of each index after treatment in typical an- tipsychotics group. After treatment,compared with typical antipsychotics group, the N2 PL and P3PL in ERP in atypical antipsychotics group were shortened, while the P3 amp was increased, but the serum Hcy level was decreased, and there were significant differences （Pa 〈 0. O1 ）. Conchtsions There is a certain degree of high serum Hcy level and cognitive function damage in children with schizophrenia. Atypi- cal antipsychotics treatment can obviously improve the serum Hcy level and cognitive function in patient with schizophrenia.