阿立哌唑联合利培酮对精神分裂症患者认知功能和血清学指标的影响

Effects of aripiprazole combined with risperidone on cognitive function and serological indices in patients with schizophrenia

目的:探讨阿立哌唑联合利培酮治疗精神分裂症的疗效及对患者认知功能和血清学指标的影响。方法:将本院2021年1月—2023年1月收治的60例精神分裂症患者按随机数字表法分为对照组(30例)和观察组(30例)。对照组采用利培酮治疗,起始剂量为1 mg/d,根据病情发展逐渐增加剂量,最多4~6 mg/d,1次/d;观察组采用阿立哌唑联合利培酮治疗,以1 mg/d利培酮为起始剂量,第3日增加至2 mg/d,1次/d;同时加用阿立哌唑片,初始剂量5 mg/d,2 d后增加至10 mg/d,1次/d,然后根据患者病情逐渐调整至20~25 mg/d。两组均治疗8周。比较两组临床疗效、阳性与阴性症状量表(PANSS)评分、简易精神状态检查(MMSE)、血清学指标[磷酸化雷帕霉素靶蛋白(P-mTOR)、核心蛋白多糖]、炎症因子水平[白细胞介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)]及不良反应。结果:相比于对照组,治疗后观察组总有效率更高(P<0.05)。治疗前两组PANSS各项评分比较差异无统计学意义(P>0.05);治疗后两组PANSS各项评分均低于治疗前,且观察组低于对照组(P<0.05)。治疗前两组认知功能评分比较差异无统计学意义(P>0.05),治疗后两组认知功能评分高于治疗前,且观察组高于对照组(P<0.05)。治疗前两组各血清学指标水平比较差异无统计学意义(P>0.05);治疗后两组p-mTOR水平低于治疗前,核心蛋白多糖水平高于治疗前,且观察组血清p-mTOR低于对照组,核心蛋白多糖水平高于对照组(P<0.05)。治疗前两组各炎性因子水平比较差异无统计学意义(P>0.05);治疗后两组炎性因子水平均低于治疗前,且观察组低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:精神分裂症患者采用阿立哌唑与利培酮联合治疗可提高治疗效果,改善患者认知能力,调节患者血清学指标,有效抑制机体内炎症反应,且不良反应发生率较少,值得推广到临床使用。

Objective:To investigate the efficacy of aripiprazole combined with risperidone in schizophrenia and its effects on cognitive function and serological indicators.Methods:Sixty patients with schizophrenia who were admitted to our hospital between January 2021 and January 2023 were divided into a control group(30 patients) and an observation group(30 cases)using a random number table method.The control group was treated with risperidone,starting at 1 mg/day and gradually increasing the dose according to the progression of the disease,up to 4~6 mg/dayonce/day.The observation group was treated with aripiprazole combined with risperidone,starting with 1 mg/d risperidone,increasing to 2 mg/d once/d on the3rd day;at the same time,aripiprazole tablets were added,the initial dose was 5 mg/d,and the dose was increased to 10 mg/d once/d after 2 days,and then gradually increased from 5 mg and adjusted to 20~25 mg/d according to the patient's condition.Both groups were treated for eight weeks.Clinical efficacy,positive and negative symptom scale(PANSS)scores,easy mental status examination(MMSE),serological parameters[phosphorylated rapamycin target protein(P-mTOR),core proteoglycans],inflammatory factor levels[interleukin-1 β,tumor necrosis factor alpha(TNF-α),interleukin-6(IL-6)],and adverse reactions were compared between the two groups.Results:Compared to the control group,the total effective rate of the observation group was higher after treatment(P< 0.05),and there was no significant difference in PANSS scores between the two groups before treatment(P>0.05).After treatment,the PANSS scores of both groups were lower than those before treatment,and the observation group had lower PANSS scores than the control group(P<0.05).There was no significant difference in the cognitive function scores between the two groups before treatment(P>0.05).The cognitive function scores of the two groups after treatment were higher than those before treatment,and the observation group had higher scores than the control group(P<0.05).Before treatment,there was no significant difference in the serological indices between the two groups(P>0.05).After treatment,the P-mTOR level was lower than before treatment,and the core proteoglycan level was higher than before treatment.The serum P-mTOR level in the observation group was lower than that in the control group and the core proteoglycan level was higher than that in the control group(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups before treatment(P>0.05).The levels of inflammatory factors in the two groups after treatment were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Combination therapy with aripiprazole and risperidone in patients with schizophrenia can improve treatment efficacy,enhance cognitive ability,regulate serum indicators,effectively inhibit inflammatory reactions in the body,and reduce the incidence of adverse reactions.Therefore,it is worth promoting its clinical use.