阿立哌唑联用氯氮平维持治疗对慢性精神分裂症患者认知功能的影响

Influence of Aripiprazole combined with Clozapine on cognitive function in maintenance treatment of chronic schizophrenic patients

目的:探讨阿立哌唑联用氯氮平维持治疗对慢性精神分裂症患者认知功能的影响。方法:入组40例维持期的慢性精神分裂症患者,均为阿立哌唑联用氯氮平治疗(联用组),与同期住院的40例单用氯氮平治疗的慢性精神分裂症患者(单用组)对照。分别于入组时、入组后6个月、12个月采用重复性成套神经心理状态测验(RBANS)评定患者的认知功能,并同时用PANSS量表评定患者的临床疗效,副反应量表(TESS)评定药物不良反应。结果:PANSS总评分入组时、入组后12个月两组患者之间差异无统计学意义(P>0.05),各组患者治疗前后差异也无统计学意义(P>0.05)。认知功能评定联用组患者入组后6个月开始注意功能因子分,即刻记忆因子分与入组前相比差异有统计学意义(P<0.05),其它视觉广度、言语功能、延迟记忆因子分入组前后差异无统计学意义(P>0.05),单用组患者5项因子分入组前后差异均无统计学意义(P>0.05)。总不良反应两组患者间差异有统计学意义(P<0.05)。结论:阿立哌唑联用氯氮平维持治疗是一种安全有效的治疗方法,能部分改善患者的认知功能障碍,不良反应小。

Objective：To discuss influence of Aripiprazole combined with Clozapine on cognitive function in maintenance treat-ment of chronic schizophrenic patients. Methods：40 admitted schizophrenic patients in maintenance stage, who were all treated by u-sing Aripiprazole combined with Clozapine, were used as combination group, whilethe other 40 admitted schizophrenia patients at thesame time, who were treated by Clozapine, were chosen as single group. Their cognitive functions were assess by repeatable battery forthe assessment of neuropsychological status （RBANS）, the clinical effects were evaluated by PANSS, and adverse drug reactions wereassessed by treatment emergent symptom scale （TESS） at admission and 6 and 12 months after admission. Results： There were no sta-tistical differences in the total scores of PANSS at admission and 12 months after admission between the two groups （P〉0. 05）. Therewere no statistical differences for the two groups before and after the treatment （P〉0. 05）. In the assessment of cognitive function, thecombination group began to pay attention to functional factor scores, and the immediate memorial factor score difference had the statisti-cal significance before and after admission （P〈0. 05）. There were no statistical differences in the scores of visual span, speech func-tion and delayed memorial factor for combination group before and after admission （P〉0. 05）. 5 factor scores of single group all had nostatistical differences before and after admission （P〉0. 05）. The differences in the total adverse reactions between the two groups hadthe statistical significance （P〈0. 05）. Conclusions： Aripiprazole combined with Clozapine for the maintenance treatment is a safe andeffective method, which can improve the patients＇ cognitive functional disorder with little adverse reactions.