利培酮对首发精神分裂症患者的疗效及认知功能的影响

Effects of risperidone on the efficacy and cognitive function of patients with first episode schizophrenia

目的探讨利培酮对首发精神分裂症患者的疗效及认知功能的影响。方法选取我院2011年1月~2015年1月间收治的40例首发精神分裂症患者作为观察对象,所有患者均予利培酮初始量每天1 mg,2周内逐渐加至3~5 mg/d,最大不超过6 mg/d,疗程8周。疗效评价采用阳性和阴性症状量表（PANSS）进行评定。患者的认知功能采用韦氏成人记忆测验（WMS）、简易智能状况检查（MMSE）及威斯康星卡片分类试验（WCST）进行评价。结果治疗8周后,40例患者均坚持完成治疗,其中痊愈20例,显著进步8例,进步4例,无效8例,显效率为80%（32/40）。治疗后PANSS总分、阳性症状、阴性症状、一般精神、病理评分均较治疗前显著降低（P〈0.05）。治疗8周后患者的认知功能WMS、MMSE及WCST各项评分分别较治疗前显著改善,表现为WMS再认、图片、联想、背数记忆、正确数评分增加,WCST总测验数、持续误数、随机误数评分显著降低（P〈0.05）。结论利培酮用于首发精神分裂症患者可以提高临床疗效,改善患者的认知功能,值得临床推广和应用。

Objective To investigate the effect of risperidone in treatment of first episode schizophrenia and its effect on cognitive function. Methods A total of 40 patients with first episode schizophrenia treated in our hospital from January 2011 to January 2015 were selected as the observation objects, were treated with risperidone 1 mg/d, increased 3~5 mg/d in two weeks, the maximum no more than 6 mg/d, 8 weeks of treatment. The efficacy was assessed by using positive and negative symptom scale（PANSS）. The cognitive function of patients with Wechsler Memory Scale（WMS）, Mini Mental State Examination（MMSE） and Wisconsin Card Sorting Test（WCST） were evaluated. Results After treatment for8 weeks, 40 patients were treated completely, including 20 cases cured, 8 cases significantly improved, 4 cases improved, 8 cases were ineffective, the efficiency was 80%（32/40）. PANSS total score, positive symptoms, negative symptoms, general psychiatric score, pathological score were significantly lower than before treatment（P〈0.05）. After treatment8 weeks, the scores of cognitive function WMS, MMSE, WCST were significantly improved compared with before treatment, and the performance of WMS recognition, pictures, association, the number of memory, the accuracy of the score were increased, WCST total test number, continuous error and random error were significant decreased（P〈0.05）. Conclusion Risperidone for the first episode of schizophrenia patients can improve the clinical efficacy, improve the cognitive function, it is worthy of clinical promotion and application.