精神分裂症患者认知功能损害特征及治疗效果研究

Study of characteristics of cognitive impairment and treatment effectiveness in schizophrenia patients

目的探讨精神分裂症患者认知功能损害的临床特征及治疗效果。方法对36例精神分裂症患者均12I服非典型抗精神病药物治疗，观察8周。治疗前后采用重复性成套神经心理状态测查量表和Stroop色词测验评定认知功能损害状况，采用阳性与阴性症状量表评定临床疗效。结果本组患者治疗前后重复性成套神经心理状态测查量表总分与常模比较差异均无显著性（P〉0．05），但治疗后即时记忆、语言功能和延时记忆3个因子评分与治疗前比较差异有显著性（P〈0．05或0．01）；Stroop色词测验仅字义干扰测验结果与治疗前比较差异有显著性（P〈0．05），其他项目测验治疗前后分值比较均无显著变化（P〉0．05），与常模比较差异均无显著性（P〉0．05）。治疗后阳性与阴性症状量表总分及各因子分均较治疗前呈持续性下降，治疗8周末总有效率达100％。结论精神分裂症患者存在言语记忆、注意及执行功能等认知功能的损害，非典型抗精神病药物治疗精神神分裂症疗效显著，且能改善患者的认知功能。

Objective To explore the characteristics of cognitive impairment and treatment effectiveness in schizophrenia patients. Methods Thirty-six schizophrenics were treated with oral atypical antipsychotics for 8 weeks. Before and after treatment cognitive impairments were assessed with the Repeatable Battery for the Assessment of Neuropsychological Status（RBANS）and Stroop Color Word Test （CWT） and cura- tive effects with the Positive and Negative Syndrome Scale （PANSS）. Results There were no significant differences in pre- and post-treatment total score of the RBANS between the patients and norm （P〉0.05）, but post-treatment immediate memory, language function and delay memory score had significant differences from pre-treatment （P〈0.05 or 0.01）; post-treatment word meaning interference of the CWT had significant difference from pre-treatment （P〈0.05）, other items test scores had no significant changes （P〉0.05） and no significant differences from norm （P〉0.05）. After treatment the total and each factor score of the PANSS lowered continuously compared with pre-treatment, at the end of the 8th week total ef- fective rate was 100%. Conclusion Schizophrenics have such cognitive impairments as speech memory, attention and execution dysfunction, atypical antipsychotic has an evident effect in schizophrenia, andcould improve patients＇ cognitive function.