奥氮平、利培酮对精神分裂症患者认知功能及血脂代谢水平的影响

Effect of Olanzapine and Risperidone on Cognition and Lipid Metabolism in Patients with Schizophrenia

【目的】奥氮平、利培酮对首发精神分裂症患者认知功能、血脂代谢水平的影响。【方法】回顾性分析2015年3月至2017年5月本院收治的40例首发精神分裂症患者的临床资料,根据用药情况将其分为利培酮组和奥氮平组,每组各20例。两组患者均连续治疗8周,比较两组治疗前后阳性症状评分、阴性症状评分、PANSS总分,血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及认知功能评分。【结果】治疗后,两组阳性症状、阴性症状与PANSS总分均较同组治疗前显著降低,差异具有统计学意义(P<0.05),但两组-间比较差异无统计学意义(P>0.05)。治疗后,两组血清TG、TC、LDL-C水平较治疗前显著升高,且利培酮组血清TG、TC水平均低于奥氮平组,差异具有统计学意义(P<0.05)。治疗后,两组SOP、CPT-IP、WMS-Ⅲ、HVLT-R、BVMT、NAB、MSCEIT评分较同组治疗前显著升高(P<0.05)。【结论】首发精神分裂症患者采用奥氮平或利培酮治疗均能有效改善患者的临床症状及认知功能,但是奧氮平对患者的血脂影响较利培酮更加明显。

【Objective】To investigate the effects of olanzapine on cognitive function and lipid metabolism in patients with first-episode schizophrenia.【Methods】Forty patients with first-episode schizophrenia diagnosed in our hospital from March 2015 to May 2017 were divided into the risperidone group and the olanzapine group.The patients in both groups were treated for 8 weeks.The positive symptom score,negative symptom score,PANSS total score,serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and cognitive function scores before and after treatment were compared between the two groups.【Results】After treatment,the positive symptoms>negative symptoms and PANSS total scores of the two groups were significantly lower than those of the same group before treatment(P<0.05)>but the difference between the two groups was not statistically significant(P>0.05).Before treatment,the serum levels of TG,TC,HDL-C and LDL-C in the two groups were not statistically significant(P>0.05).After treatment,the serum levels of TG,TC and LDL-C in the two groups were significantly higher than those before treatment(P<0.05),and the serum TG and TC levels in the risperidone group were lower than those in the olanzapine group(P<0.05).After treatment,the SOP,CPT-IP,WMS-ⅢHVLT-R,BVMT,NAB,and MSCEIT scores of the two groups were significantly higher than those of the same groups before treatment(P<C0.05).[Conclusion]Patients with first-episode schizophrenia treated with olanzapine and risperidone can effectively improve clinical symptoms and cognitive function;however,olanzapine Has more pronounced effect on blood lipids than risperidone.