维生素D联合齐拉西酮对精神分裂症患者认知功能的影响

Effects of vitamin D combined with ziprasidone on cognitive function in patients with schizophrenia

目的 观察维生素D联合齐拉西酮对精神分裂症患者认知功能的影响。方法 选取2016年10月—2018年4月粤北第三人民医院收治的精神分裂症患者118例,按照随机数字分配法分为观察组和对照组,各59例。对照组单用齐拉西酮治疗,观察组在对照组基础上加用维生素D治疗,2组均治疗7周。比较2组治疗前后阳性和阴性症状量表(PANSS)评分、精神分裂症认知功能评测量表(SCoRS)评分、血清学指标[胶质纤维酸性蛋白(GFAP)、脑源性神经营养因子(BDNF)]水平、认知功能及不良反应。结果 治疗3、7周后,2组PANSS评分及SCoRS评分均较治疗前降低,且观察组低于对照组(P均<0.01);2组GFAP、BDNF水平均较治疗前升高,且观察组高于对照组(P<0.05或P<0.01);治疗7周后,2组额叶、颞叶及顶叶认知功能均较治疗前改善,且观察组改善程度均大于对照组(P<0.05或P<0.01);观察组不良反应总发生率为30.51%,低于对照组的52.54%(χ^(2)=5.898,P=0.015)。结论 维生素D联合齐拉西酮治疗精神分裂症疗效优于单纯使用齐拉西酮,可有效改善患者认知功能,降低不良反应发生率,具有较高的安全性,值得推广与应用。

Objective To observe the effect of vitamin D combined with ziprasidone on cognitive function in patients with schizophrenia.Methods A total of 118 schizophrenic patients admitted to the Third People′s Hospital of North Guangdong from October 2016 to April 2018 were selected and divided into an observation group and a control group based on a random number allocation method,with 59 patients in each group.The control group was treated with ziprasidone alone,while the observation group was treated with vitamin D on the basis of the control group.Both groups were treated for 7 weeks.The positive and negative symptom scale(PANSS)scores,cognitive function rating scale for schizophrenia(SCoRS)scores,serological indicators[glial fibrillary acidic protein(GFAP),brain derived neurotrophic factor(BDNF)]levels,cognitive function and adverse reactions were compared between the two groups before and after treatment.Results After 3 and 7 weeks of treatment,the PANSS score and SCoRS score in both groups were lower than those before treatment,and the observation group was lower than the control group(all P<0.01);The levels of GFAP and BDNF in both groups were higher than before treatment,and the observation group was higher than the control group(P<0.05 or P<0.01);After 7 weeks of treatment,the cognitive functions of the frontal,temporal,and parietal lobes in both groups improved compared to those before treatment,and the improvement degree in the observation group was greater than that in the control group(P<0.05 or P<0.01);The total incidence of adverse reactions in the observation group was 30.51%,lower than 52.54%in the control group(χ^(2)=5.898,P=0.015).Conclusion Vitamin D combined with ziprasidone is more effective in the treatment of schizophrenia than ziprasidone alone,it can effectively improve patients′cognitive function,reduce the incidence of adverse reactions,and has high safety,which is worthy of promotion and application.