利培酮联合舍曲林对精神分裂症阴性症状患者临床效果及sTNFRs、神经电生理特征的影响

Clinical effect of risperidone combined with sertraline on patients with negative symptoms of schizophrenia,and its influence on sTNFRs and neuroelectrophysiological characteristics

目的 分析精神分裂症阴性症状患者联用利培酮及舍曲林治疗的临床疗效。方法 86例精神分裂症阴性症状患者,采用随机数字表法分为对照组和观察组,每组43例。对照组应用利培酮治疗,观察组在对照组基础上联合舍曲林治疗。对比两组临床效果,治疗前后阴性症状量表(SANS)评分、血清可溶性肿瘤坏死因子受体(sTNFRs)水平、神经电生理特征指标及药物不良反应发生情况。结果 治疗前,两组交流障碍、情感迟钝、思维频发、社交障碍与性格孤僻评分对比,差异无统计学意义(P>0.05)。治疗后,观察组交流障碍、情感迟钝、思维频发、社交障碍与性格孤僻评分分别为(4.12±0.13)、(4.10±0.22)、(3.41±0.85)、(3.62±1.02)、(3.43±0.29)分,均低于对照组的(5.16±0.39)、(5.21±0.36)、(5.69±1.16)、(5.10±1.13)、(4.65±1.01)分,差异有统计学意义(P<0.05)。治疗前,两组血清s TNFRs水平对比,差异无统计学意义(P>0.05)。治疗1、2、3个月后,观察组血清s TNFRs水平分别为(2326.53±29.62)、(1806.53±20.18)、(1341.19±18.62)ng/L,均明显低于对照组的(3010.19±28.59)、(2416.39±22.62)、(2118.63±20.86)ng/L,差异有统计学意义(P<0.05)。治疗前,两组P300、错误相关负电位(ERN)、N250、后正电位(LPP)对比,差异无统计学意义(P>0.05)。治疗后,观察组P300、ERN、N250分别为(5.38±0.65)、(9.53±0.86)、(8.52±0.86)mV,均明显高于对照组的(3.57±0.30)、(6.15±0.49)、(6.12±0.60)mV,LPP(5.22±0.65)mV低于对照组的(7.61±0.76)mV,差异有统计学意义(P<0.05)。观察组治疗总有效率95.35%明显高于对照组的81.40%,差异有统计学意义(P<0.05)。两组药物不良反应发生率对比差异无统计学意义(P>0.05)。结论 对精神分裂症阴性症状患者联合应用利培酮及舍曲林可获得确切的治疗效果,有利于改善其阴性症状,降低sTNFRs水平并改善神经电生理特征。

Objective To analyze the clinical efficacy of risperidone combined with sertraline on patients with negative symptoms of schizophrenia.Methods A total of 86 patients with negative symptoms of schizophrenia were divided into control group and observation group according to the random numerical table,with 43 cases in each group.The control group was treated with risperidone,and the observation group was treated with sertraline on the basis of the control group.Both groups were compared in terms of clinical effects,Scale for the Assessmentof Negative Symptoms(SANS)score,serum soluble tumor necrosis factor receptors(sTNFRs)level and neuroelectrophysiological characteristics before and after treatment,and the occurrence of adverse drug reactions.Results Before treatment,there was no statistically significant difference between the two groups in the scores of communication disorder,emotional retardation,frequent thinking,social disorder and personality isolation(P>0.05).After treatment,the scores of communication disorder,emotional retardation,frequent thinking,social disorder and personality isolation were(4.12±0.13),(4.10±0.22),(3.41±0.85),(3.62±1.02)and(3.43±0.29)points,in the observation group,which were lower than those of(5.16±0.39),(5.21±0.36),(5.69±1.16),(5.10±1.13)and(4.65±1.01)points in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in serum sTNFRs levels between the two groups(P>0.05).After 1,2 and 3 months of treatment,the serum sTNFRs levels were(2326.53±29.62),(1806.53±20.18)and(1341.19±18.62)ng/L in the observation group,which were significantly lower than those of(3010.19±28.59),(2416.39±22.62)and(2118.63±20.86)ng/L in the control group,and the differences were statistically significant(P<0.05).Before treatment,P300,error-related negativity(ERN),N250,and late positive potential(LPP)were compared between the two groups,and the differences were not statistically significant(P>0.05).After treatment,P300,ERN,and N250 were(5.38±0.65),(9.53±0.86),and(8.52±0.86)mV in the observation group,which were significantly higher than those of(3.57±0.30),(6.15±0.49),and(6.12±0.60)mV in the control group;LPP of(5.22±0.65)mV in the observation group was lower than that of(7.61±0.76)mV in the control group;the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 95.35%,which was significantly higher than that of 81.40%in the control group,and the difference was statistically significant(P<0.05).The difference in the incidence of adverse drug reactions between the two groups was not statistically significant(P>0.05).Conclusion The combination of risperidone and sertraline can obtain a definite therapeutic effect for patients with negative symptoms of schizophrenia,which is beneficial to improve the negative symptoms,reduce the level of sTNFRs and improve the neuroelectrophysiological characteristics.