长期服用帕利哌酮对首发精神分裂症患者社会认知功能的影响

Long-term effects of paliperidone on social cognitive function in patients with first-episode schizophrenia

目的 分析长期服用帕利哌酮对首发精神分裂症患者社会认知功能的影响.方法 对2012年6月至2013年5月在华中科技大学同济医学院附属精神卫生中心就诊并符合纳入标准的50例（观察组）首发精神分裂症患者采取12周的帕利哌酮3 ～ 12 mg/d口服治疗,通过阳性与阴性症状量表（PANSS）、蒙特利尔认知评估量表（MoCa）、连续作业测验（CPT）、数字划销测验（CT）、韦氏成人记忆量表（WMS-R）、威斯康星卡片分类测验（WCST）分析患者治疗前后的得分差异,并与50例正常人（对照组）进行对比分析.结果 治疗12周后,观察组患者PNASS量表中各项指标得分较治疗前均有明显改善（P＜0.01）.通过MoCa量表可知,治疗后观察组患者与对照组仍有一定差距,但与治疗前相比已改善许多,尤其是记忆、执行功能、注意力、语言、空间及时间定向[（2.9±1.3）分比（1.2±1.4）分、（3.3±0.5）分比（2.8±0.4）分、（5.59±0.20）分比（4.68±0.33）分、（2.89±0.34）分比（2.28±0.43）分、（3.67±0.84）分比（3.32±0.99）分、（1.94±0.08）分比（1.89±0.13）分]（P ＜0.01）;CPT、CT、WMS-R、WCST结果表明,患者治疗后CPT平均用时、CT净分、失误率,WMS-R量表中数字广度及数字符号分值均较治疗前有明显改善[（592±85） ms比（632±100） ms、（109±10）分比（95±14）分、（15.3±2.4）％比（19.2±3.6）％、（18±3）分比（15±3）分,（21±4）分比（20±3）分]（P＜0.05）;另外,通过WCST量表分析可知,患者治疗前后在随机错误数、持续错误数、卡片总数上得分差异均有统计学意义[（22±12）分比（35±15）分、（20±13）分比（26±16）分、（70±20）分比（88±25）分]（t=3.88、2.13、3.23,P＜0.05）.结论 帕利哌酮具有良好的临床治疗效果,可明显提高首发精神分裂症患者社会认知功能.

Objective To analyze the long-term effects of paliperidone on the social cognitive function in patients with first-episode schizophrenia. Methods Totally 50 patients with first-episode schizophrenia （observation group）from June 2012 to May 2013 were enrolled and were orally administrated with paliperi- done （3-12 mg/d, 12 weeks）. In addition, 50 normal persons were enrolled as control group. The positive and negative syndrome scale （PANSS） , Montreal cognitive assessment （MoCa） , continuous performance test （CPT） , digital cancellation test （CT） , Wechsler adult memory scale （WMS-R） and Wisconsin card sorting test （WCST） were used to analyze the effect of paliperidone. Results After 12 weeks of treatment, the indi- cators of PNASS were significantly improved compared with pretreatment （ all P 〈 0.01 ） ; the MoCa scale shows that compared with pretreatment, the memory, executive function, attention, language, spatial and temporal orientation were all improved after treatment[ （2.9 ± 1.3 ） scores vs （ 1.2 ± 1.4 ） scores, （ 3.3 ± 0.5）scoresvs （2.8±0.4）scores, （5.59±0.20）scores vs （4.68±0.33）scores, （2.89±0.34）scores vs （2.28 ± 0.43 ） scores, （ 3.67 ± 0.84） scores vs （ 3.32 ± 0.99 ） scores, （ 1.94 ± 0.08 ） scores vs （ 1.89 ± 0. 13 ） scores （all P 〈 0.01 ） ; after treatment, the average time in CPT, the net points and error rate in CT, digital breadth and number sign scores in WMS-R were all significantly improved compared with pretreatment [ （592 ± 85）ms vs （632±100）ms, （109 ±10 ） scores vs （ 95 ±14 ） scores , （15.3±2.4）% vs （19.2 ±3.6）%, （18± 3 ） scores vs （ 15 ± 3 ） scores, （ 21 ± 4） scores vs （20 ± 3 ） scores ] （ all P 〈 0.05 ） ; moreover, in WCST scale analysis, the random errors, continuous errors and total number of the cards were all significantly reduced after treatment. were statistically significant on the in [ （22 ± 12 ） scores vs （35 ± 15 ） scores, （20 ± 13 ） scores vs （26 ± 16 ） scores, （ 70 ± 20 ） scores vs （ 88 ±25 ） scores] Conclusion Paliperidone can significantly improve the social cognitive function in patients with first-episode schizophrenia society.