吡拉西坦对奥氮平合并无抽搐电休克治疗精神分裂症患者认知功能的影响

Influence of piracetam injection on cognitive function of patients with schizophrenia treated with olanzapine and modified electroconvulsive therapy

目的:探讨吡拉西坦注射液对奥氮平合并无抽搐电休克治疗(MECT)的精神分裂症患者认知功能的影响。方法:150例急性期精神分裂症患者采用随机数字表法分为A组(奥氮平单药)、B组(奥氮平联合MECT)和C组(奥氮平联合MECT加用吡拉西坦注射液),各50例,观察6周。采用阳性和阴性症状量表(PANSS)、精神分裂症认知功能成套测验共识版(MCCB)于治疗前、后评估各组疗效及认知功能,并记录不良反应发生率。结果:与治疗前相比,各组PANSS总分及各项评分显著下降(P均<0.05);B、C两组PANSS阳性症状分、阴性症状分、一般精神病理分及总分治疗前后差值明显高于A组(P均<0.05);B、C两组间比较差异无统计学意义。经不同方案治疗后,B组MCCB语言记忆、视觉记忆评分较治疗前明显增加,A、C两组MCCB符号编码、语言记忆、视觉记忆、空间广度、数字序列评分较治疗前、及B组明显增高(P均<0.05);A、C两组间比较差异无统计学意义(P>0.05)。各组不良反应发生率比较差异无统计学意义(P>0.05)。结论:吡拉西坦可减轻MECT对精神分裂症患者认知功能的影响。

Objective： To investigate the effect of piracetam injection on cognitive function of patients with schizophrenia treated with olanzapine and modified electroconvulsive therapy（ MECT）. Method： A total of 150 acute schizophrenia patients from our hospital were enrolled; all of them were randomly divided into A group（ 50 cases）,B group（ 50 cases） and C group（ 50 cases）. A group received olanzapine therapy,B group was given MECT plus olanzapine and group C was given piracetam injection besides the same therapy as B group. Positive and negative syndrome scale（ PANSS） and MCCB. The consensus cognitive battery were measured and the scores were compared before and after treatment. complications were recorded. Results： Compared with before treatment,the PANSS positive score,negative score,general psychopathology and total score of group A,B and C had significantly decreased（ P〈0. 05）,while PANSS positive,negative,general psychopathology and total before-after score differenc in group B and C were significantly greater than group A（ P〈0. 05）. After treatment,the language memory and visual memory score of group B had increased significantly（ P〈0. 05）,the scores of cognitive functions such as sign coding,language memory,visual memory,spatial breadth and number sequence in patients A and C group were significantly higher than before treatment,and the scores of cognitive function were higher than those in group B（ P〈0. 05）. There was no statistically significant difference in the scores of cognitive functions between group A and C（ P〉0. 05）. There was no statistically significant difference in the incidence of adverse reactions among three groups（ P〉0. 05）. Conclusion： Piracetam can improve the cognitive function of patients receiving MECT.