富马酸喹硫平片联合碳酸锂对双相情感障碍躁狂发作患者认知功能的影响

The effect of quetiapine fumarate tablets effect combined with lithium carbonate in the cognitive function of the patients with manic episodes of bipolar disorder

目的探讨富马酸喹硫平片联合碳酸锂对双相情感障碍躁狂发作患者认知功能的影响。方法将2014年9月至2016年9月于该院治疗的90例双相情感障碍躁狂发作患者按照随机数字表法分为对照组和观察组,每组45例。对照组采用碳酸锂治疗,观察组采用富马酸喹硫平片与碳酸锂联合用药治疗。比较两组患者用药前后的Bech-Rafaelsen躁狂量表(BRMS)评分、临床有效率、认知功能(执行力、记忆力、注意力)、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)]等指标。结果两组患者治疗后BRMS评分均比治疗前明显降低,差异有统计学意义(P<0.05),且观察组治疗后的BRMS评分、临床疗效明显优于对照组,差异有统计学意义(P<0.05);两组患者治疗前后的执行力水平(WCST)、记忆力水平(HVLTR)差异无统计学意义(P>0.05),但注意力水平(CPT)改善明显,且观察组明显优于对照组,差异有统计学意义(P<0.05);两组患者治疗前后TNF-α、IL-4水平均明显下降,IL-10水平明显升高,差异均有统计学意义(P<0.05),观察组治疗后TNF-α、IL-1水平明显低于对照组,IL-10水平明显高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率对比差异无统计学意义(P>0.05)。结论富马酸喹硫平片与碳酸锂联合用药可明显改善双相情感障碍躁狂发作患者的注意力水平,明显降低其BRMS评分,并改善炎性因子水平,具有一定临床应用价值。

Objective To investigate the effect of quetiapine fumarate tablets combined with bonate in the cognitive function of the patients with manic episodes of bipolar disorder. Methods From car- Sep- tember 2014 to September 2016 in our hospital treatment of 90 cases of manic episode of bipolar disorder pa- tients were divided into two groups. The control group was treated with ithium carbonate treatment,observa- tion group was treated with quetiapine and lithium carbonate combined treatment. Two groups were compared before and after treatment of the Bech-Rafaelsen Mania Rating Scale （BRMS） score,clinical efficiency,cogni- tive function （including execution, memory, attention）, inflammatory cytokines [tumor necrosis factor a （TNF-α） ,interleukin-4 （IL-4） ,interleukin-10 （IL-10）] and other indicators. Results BRMS score and clinical efficacy：BRMS scores after treatment were significantly lower than that before treatment in two groups of pa- tients（P^0.05）. The BRMS score and clinical efficacy of the observation group were significantly better than those of the control group, the difference was statistically significant （P〈 0. 05）. Cognitive function： two groups of patients before and after the level of implementation （WCST test value）,memory level （HVLT-R test value） were not significantly improved （P〉0.05）. But the level of attention （CPT test） improved signifi- cantly （P〈0.05）. And the observation group was significantly better than the control group （P〈0.05）. In- flammatory factors：in two groups of patients before and after treatment,TNF-α, IL-4 levels were significantly decreased （P〈0.05）,IL-10 levels were significantly higher （P〈0.05）. After treatment,TNF-α and IL-1 in the observation group were significantly lower than those in the control group, and IL-10 was significantly higher than that in the control group. The difference was statistically significant （P〈0.05）. There was no sig- nificant difference in the incidence of adverse reactions between the two groups （P〉0.05）. Conclusion the combination of quetiapine fumarate tablets and lithium carbonate can significantly improve the cognitive func-tion of patients with manic episode of bipolar disorder, and decreased the BRMS score and obviously improve the level of inflammatory factors.