摘要
目的比较阿立哌唑与奥氮平改善慢性精神分裂症病人的努力性认知、执行功能、决策功能等认知功能的效果。方法选择2017年11月至2018年11月无锡市精神卫生中心精神科收治的慢性精神分裂症89例,采用随机数字表法将其分为奥氮平组(n=44)和阿立哌唑组(n=45),两组病人分别采用奥氮平、阿立哌唑进行治疗8周。应用阳性和阴性精神症状评定量表(PANSS)、数字广度测试(DS)、威斯康星卡片分类测验(WSCT)以及爱荷华赌博任务(IGT)进行测定对比两组病人治疗后的努力性认知、执行功能、决策功能等认知功能的改善情况。结果治疗后,两组病人PANSS量表总分、阳性量表、阴性量表评分显著低于治疗前[奥氮平组分别为(67.18±5.78)分、(17.31±2.68)分、(17.81±2.95)分比(82.29±6.41)分、(22.68±4.09)分、(21.29±4.47分);阿立哌唑组分别为(63.79±3.77)分、(16.12±2.41)分、(17.34±2.25)分比(82.36±6.38)分、(22.57±4.17)分、(21.36±3.42)分](P<0.05),但是两组病人间的评分相比差异无统计学意义(P>0.05)。治疗后,两组病人DS测试评分均高于治疗前[奥氮平组为(8.32±1.55)分比(10.87±1.61)分,阿立哌唑组为(8.37±1.59)分比(12.63±1.45)分](P<0.05),且阿立哌唑组病人DS测试评分高于奥氮平组(P<0.05)。治疗后,两组病人的WCST测验完成分类数高于治疗前,错误应答总数及持续错误应答数均低于治疗前[奥氮平组分别为(3.51±1.14)分、(36.42±5.11)分、(11.51±2.65)分比(4.94±1.45)分、(12.39±3.02)分、(6.07±1.27)分;阿立哌唑组分别为(3.55±1.16)分、(38.88±5.24)分、(11.35±2.57)分比(5.21±1.61)分、(11.45±2.98)分、(5.74±1.15)分](P<0.05),但是两组病人间的WCST测试结果相比差异无统计学意义(P>0.05)。治疗后,两组病人的IGT各个模块得分及总得分与治疗前相比均有所升高[奥氮平组总得分为(−8.98±1.11)分比(−0.99±0.35)分;阿立哌唑组总得分为(−9.01±1.57)分比(−0.85±0.26)分](P<0.05),两组病人治疗后的IGT各个模块得分及总得分之间相比差异无统计学意义(P>0.05)。结论阿立哌唑、奥氮平对于慢性精神分裂症病人的努力性认知、执行功能、决策功能等认知功能均有一定的改善作用,阿立哌唑治疗相对而言对病人努力性认知的改善作用更明显。
Objective To compare the effects of aripiprazole and olanzapine on the cognitive functions including cognitive effort,performance and decision-making in patients with chronic schizophrenia.Methods Eighty-nine patients with chronic schizophrenia,admitted to Department of Psychiatry of Wuxi Mental Health Center from November 2017 to November 2018,were setelced and ran⁃domized into olanzapine group(n=44)and aripiprazole group(n=45)by random digital table method.Patients were treated with olanzap⁃ine and aripiprazole respectively for 8 weeks.The positive and negative symptom scale(PANSS),the digital span test(DS),the Wiscon⁃sin card sorting test(WSCT)and the Iowa gambling task(IGT)were used to compare the improvement in cognitive functions including⁃cognitive effort,performance and decision-making after treatment in the two groups.Results After treatment,the total score,positive scale and negative scale scores of PANSS scale in both groups were significantly lower than those before treatment[olanzapine group:(67.18±5.78)points,(17.31±2.68)points,(17.81±2.95)points vs.(82.29±6.41)points,(22.68±4.09)points,(21.29±4.4)points;aripipra⁃zole group:(63.79±3.77)points,(16.12±2.41)points,(17.34±2.25)points vs.(82.36±6.38)points,(22.57±4.17)points,(21.36±3.42)points,respectively](P<0.05),but there was no significant difference between the two groups(P>0.05).After treatment,the scores of DS in both groups were higher than those before treatment[olanzapine group:(8.32±1.55)points vs.(10.87±1.61)points;aripiprazole group:(8.37±1.59)points vs.(12.63±1.45)points],and the scores of DS in aripiprazole group were significantly higher than those in olanzapine group(P<0.05).After treatment,the number of sorting completed in WCST test in both groups was higher than that before treatment,and the total number of error responses and the number of persistent error responses were lower than those before treatment[olanzapine group:(3.51±1.14)points,(36.42±5.11)points,(11.51±2.65)points vs.(4.94±1.45)points,(12.39±3.02)points,(6.07±1.27)points;aripiprazole group:(3.55±1.16)points,(38.88±5.24)points,(11.35±2.57)points vs.(5.21±1.61)points,(11.45±2.98)points,(5.74±1.15)points,respectively](P<0.05),but there was no significant difference in the results of WCST test between the two groups(P>0.05).After treatment,the scores of each module and total scores of IGT modules in both groups were higher than those before treat⁃ment[total scores of olanzapine group:(−8.98±1.11)points vs.(−0.99±0.35)points;total scores of aripiprazole group:(−9.01±1.57)points vs.(−0.85±0.26)points](P<0.05),but there were no significant differences in the scores of each module and total scores of IGT modules between the two groups after treatment(P>0.05).Conclusions Aripiprazole and olanzapine can improve cognitive effort,per⁃formance,and decision-making in patients with chronic schizophrenia.Aripiprazole therapy has a more obvious effect on the improve⁃ment in cognitive effort.
作者
过婷
吴越
周振和
GUO Ting;WU Yue;ZHOU Zhenhe(Department of Psychiatry,Wuxi Mental Health Center,Wuxi,Jiangsu 214001,China)
出处
《安徽医药》
CAS
2022年第3期617-621,共5页
Anhui Medical and Pharmaceutical Journal
基金
无锡市卫生计生科研面上项目(MS201756)。
关键词
精神分裂症
奥氮平
阿立哌唑
努力性认知
执行能力
决策功能
Schizophrenia
Olanzapine
Aripiprazole
Nudinous cognition
Executive ability
Decision-making function
