齐拉西酮与氯丙嗪对首发精神分裂症患者心电图及认知功能的影响比较

Effects of ziprasidone and chlorpromazine on the ECG and cognitive function of patients with first episode of schizophrenia

目的：探讨齐拉西酮与氯丙嗪对首发精神分裂症患者心电图及认知功能的影响。方法将90例首发精神分裂症患者采用数字表法随机分为两组，每组各45例，其中对照组给予氯丙嗪，观察组口服齐拉西酮，比较两组临床疗效及治疗前后认知功能和心电图结果。结果观察组和对照组治疗后阳性和阴性症状量表（PANSS）评分分别为（57．78±4．16）分和（58．43±4．33）分，均较治疗前的（72．62±4．66）分和（72．39±4.87）分显著减少（t＝7．15、7．46，均P＜0．05），但两组间差异无统计学意义（均P＞0．05）；观察组治疗后威斯卡星卡片分类测试（WCST）总测验次数、持续错误数和数字化消测验（CT）失误率分别为（73．32±5．08）、（40．35±4．15）和（12．72±2．00）％，均较治疗前的（86．43±5．58）、（67．72±4．26）和（21．02±2．33）％及对照组的（84．32±5．16）、（65．82±4．25）和（20．05±2．20）％显著减少（ t＝6．84、7．21、7．85、7．52、8．21、8．12，均P＜0．05）；WCST分类完成数和CT净分值分别为（5．32±0．40）和（125．83±11．65）分，均较治疗前的（3.41±0．38）和（102．82±10．72）分及对照组的（3．52±0．39）和（108．37±10．24）分显著增加（ t＝6．72、7.11、7．01、7．53，均P＜0．05）；观察组治疗后心电图异常发生率为22．22％，显著低于对照组的55．56％（χ2＝11．02，P＜0．05）。结论齐拉西酮与氯丙嗪治疗首发精神分裂症疗效相当，但齐拉西酮可明显改善患者认知功能，且对患者心电图影响小，临床安全性高。

Objective To investigate the effects of ziprasidone and chlorpromazine on the ECG and cognitive function of patients with first episode of schizophrenia .Methods According to the digital table ,90 patients with first-episode schizophrenia were divided into two groups ,45 cases in each group .The control group was given chlorproma-zine,while the observation group received oral ziprasidone .Clinical efficacy,cognitive function and ECG results were compared before and after treatment .Results The PANSS scores of the study group and the control group were （57.78 ±4.16） points and （58.43 ±4.33） points after treatment,which were significantly lower than （72.62 ± 4.66）points and （72.39 ±4.87）points before treatment （t=7.15,7.46,all P〈0.05）,but the differences were not significant between the two groups （all P〉0.05）.The total number of tests of WCST ,continuous errors and CT error rate in study group after treatment were （73.32 ±5.08）,（40.35 ±4.15） and （12.72 ±2.00）%,which were signif-icantly lower than （86.43 ±5.58）,（67.72 ±4.26） and （21.02 ±2.33）%before treatmemt and （84.32 ±5.16）, （65.82 ±4.25） and （20.05 ±2.20）%in the control group（t=6.84,7.21,7.85,7.52,8.21,8.12,all P〈0.05）. WCST categories completed and the number of CT net scores were （5.32 ±0.40） and （125.83 ±11.65） points, which were significantly higher than （3.41 ±0.38） and （102.82 ±10.72） points before treatment and （3.52 ± 0.39） and （108.37 ±10.24）points in the control group,the differences were statistically significant （t=6.72,7.11, 7.01,7.53,all P〈0.05）.The incidence rate of abnormal ECG in study group was 22.22% after treatment,which was significantly lower than 55.56% in the control group（χ2 =11.02,P〈0.05）.Conclusion Ziprasidone and chlorpromazine have a equivalent efficacy in the treatment of first-episode schizophrenia ,but ziprasidone can signifi-cantly improve cognitive function and has little effect on ECG ,it is safe.