帕利哌酮对精神分裂症患者临床症状、认知功能及神经营养因子的影响

Effects of paliperidone on clinical symptoms, cognitive function and serum neurotrophic factor in patients with schizophrenia

目的 探讨帕利哌酮对精神分裂症患者的临床症状、认知功能及神经营养因子水平的影响,为临床精神分裂症的合理用药提供参考。方法 选取在天津市安定医院住院的符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的患者60例为研究组,同期选取60例健康志愿者作为对照组。研究组接受帕利哌酮治疗12周。于治疗前后采用阳性和阴性症状量表(PANSS)评定研究组临床症状;采用Stroop测验(SCWT)、数字符号编码测验(DSCT)、持续操作测验(CPT)和连线测验A(TMTA)评定对照组和研究组认知功能;采用酶联免疫吸附技术检测两组血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)和神经营养因子3(NT-3)水平。结果 研究组治疗前后PANSS总评分比较差异有统计学意义[(78.12±11.84)分 vs.(38.45±7.24)分, Z=24.14,P <0.01];治疗后,研究组认知功能指标(SCWT、CPT、DCST及TMTA时间)、BDNF、NGF及NT-3水平均较治疗前高,但仍低于对照组,差异均有统计学意义( P 均<0.01)。结论 帕利哌酮有助于改善精神分裂症患者的临床症状和认知功能,治疗机制可能与上调血清神经营养因子水平有关。

Objective To investigate the effects of paliperidone on clinical symptoms,cognitive function and serum neurotrophic factor in patients with schizophrenia,in order to provide a reference for clinical rational drug application. Methods Sixty patients who were hospitalized in Tianjin Anding Hospital and were compliance with the International Classification of Diseases, tenth edition (ICD-10) schizophrenia diagnostic criteria were selected as the study group. Meanwhile, 60 healthy volunteers were recruited as the control group.The study group patients were treated with paliperidone for 12 weeks.And the clinical symptoms were evaluated with the Positive and Negative Syndrome Scale(PANSS). The cognitive function of subjects before and after treatment were evaluated by Stroop Color-Word Test (SCWT),Digit-Symbol Coding Test (DSCT),Continuous Performance Test (CPT) and Trail Making Test-A(TMTA). The serum levels of Brain derived neurotrophic factor (BDNF),Nerve Growth Factor (NGF) and Neurotrophin 3 (NT-3) were measured by enzyme-linked immunosorbent assay. Results PANSS total score between before and after treatment of the study group was statistically significant [(78.12±11.84)vs.(38.45±7.24), Z=24.14, P <0.01]. In the study group, the cognitive function index (SCWT、CPT、DCST and TMTA), BDNF, NGF and NT-3 levels were higher than before treatment, but still lower than the control group, and the difference were all statistically significant ( P <0.01). Conclusion Paliperidone could improve the clinical symptoms and cognitive function in patients with schizophrenia,and its treatment mechanism may be related to up-regulate the levels of serum neurotrophic factor.