[1]赵　瑾,杜云红,杨　鸽,等.奥氮平对首发精神分裂症患者认知功能的潜在作用[J].新乡医学院学报,2016,33(5):387-390.[doi:10.7683/xxyxyxb.2016.05.011]
　ZHAO Jin,DU Yun-hong,YANG Ge,et al.Potential effect of olanzipine on cognitive function of first-episode schizophrenia[J].Journal of Xinxiang Medical University,2016,33(5):387-390.[doi:10.7683/xxyxyxb.2016.05.011]
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奥氮平对首发精神分裂症患者认知功能的潜在作用
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
33
期数:
2016年5
页码:
387-390
栏目:
临床研究
出版日期:
2016-05-05

文章信息/Info

Title:
Potential effect of olanzipine on cognitive function of first-episode schizophrenia
作者:
赵　瑾; 杜云红; 杨　鸽; 吕路线
（新乡医学院第二附属医院精神科，河南　新乡　453002）
Author(s):
ZHAO Jin; DU Yun-hong; YANG Ge; LYU Lu-xian
（Department of Psychiatry，the Second Affiliated Hospital of Xinxiang Medical University，Xinxiang 453002，Henan Province,China）
关键词:
奥氮平; 首发精神分裂症; 认知功能; 精神分裂症认知功能成套测试
Keywords:
olanzapine; first-episode schizophrenia; cognitive function; MATRICS consensus cognitive battery
分类号:
R749.3
DOI:
10.7683/xxyxyxb.2016.05.011
文献标志码:
A
摘要:
目的　探讨首发精神分裂症患者认知功能的损害情况，了解奥氮平单一治疗对患者认知功能的潜在作用。方法　将34例首发精神分裂症患者（完成研究30例，研究组）和30例健康对照者（正常对照组）纳入研究，研究组患者采用奥氮平单一治疗8周，观察其治疗前后临床症状改善情况，分别于治疗前和治疗后8周对其进行精神分裂症认知功能成套测试（MCCB）和阳性与阴性症状量表（PANSS）评分，并与正常对照组MCCB测试结果进行比较。结果　研究组30例患者治疗8周后痊愈16例，显著进步14例，有效率为100.0%，显效率为100.0%；研究组患者治疗后PANSS总分和各分项得分均显著下降（P<0.05），PANSS平均减分率达（72.9±9.5）%。研究组患者治疗前连线测试完成时间显著长于正常对照组，符号编码、注意力/警觉性、工作记忆、言语记忆、视觉记忆以及推理与解决问题等得分均显著低于正常对照组（P<0.01，P<0.05）。治疗8周后，研究组患者连线测试完成时间较治疗前显著缩短（P<0.01），符号编码(P<0.05)和工作记忆(P<0.01)得分较治疗前显著升高，注意力/警觉性、言语记忆、视觉记忆、推理和解决问题等得分与治疗前比较差异均无统计学意义（P>0.05）；与正常对照组比较，工作记忆和视觉记忆得分差异无统计学意义（P>0.05），但连线测试时间仍较长，符号编码、注意力/警觉性、言语记忆和推理解决问题等得分仍较低（P<0.05）。相关分析结果显示，治疗前研究组患者的认知功能与PANSS总分及各分项得分无相关性，经奥氮平治疗后，推理与解决问题得分与PANSS中的一般病理得分呈正相关（r=0.390，P=0.037）。结论　首发精神分裂症患者存在广泛的认知功能损害，奥氮平单一治疗可部分改善操作速度及工作记忆功能；首发精神分裂症患者认知功能和临床症状无相关性，认知功能损害是精神分裂症独立的症状之一。
Abstract:
Objective　To investigate the impairments of cognitive function in first-episode schizophrenia patients and analyse the potentially effectiveness of olanzapine monotherapy on the cognitive function first-episode schizophrenia patients.Methods　The thirty-four first-episode schizophrenia(30 patients finished the study，research group) and 30 healthy people(normal control group)were enrolled in this study.The patients in research group were given olanzapine monotherapy for eight weeks and the changes of clinical symptoms were observed before and after treatment.The MATRICS consensus cognitive battery(MCCB) and positive and negative syndrome scale(PANSS) scores of cases in the two groups were assessed before treatment and eight weeks after treatment，and the results were compared between the two groups.Results　After eight weeks olanzapine monotherapy，16 in 30 patients got recovery，and 14 of 30 patients got marked improvement，and the effective rate and excellence rate were 100.0%.Compared with before treatment，the PANSS total scores and each item scores of patients in research group were decreased after treatment（P<0.05）；the average reduction rate was（72.9±9.5）%.Before treatment，the completion time of patients in trailing marking test in research group was longer than that in normal control group；the scores of the symbolic coding test，attention/vigilance，working memory，verbal learning，visual learning(P<0.05) and reasoning and problem solving of patients in research group were lower than those in normal control group（P<0.01，P<0.05）.After eight weeks olanzapine monotherapy，the completion time of trailing marking test of patients in research group was shorter than before treatment(P<0.01)；the scores of the symbolic coding test and working memory were increased compared with before treatment(P<0.05，P<0.01)；there was no statistic difference of the score of verbal learning，visual learning and reasoning and problem solving between before and after treatment(P>0.05).There was no statistic difference of the score of working memory and visual learning between the normal control group and research group（P>0.05）；but the completion time of trailing marking test was longer，the scores of symbolic coding test，attention/vigilance，verbal learning，reasoning and problem solving of patients in research group were lower than those in normal control group(P<0.05).The correlation analysis results showed that there was no correlation between the cognitive function of the patients and the total score of PANSS and the score of each item before treatment(P>0.05).After treatment，the scores of reasoning and problem solving were positive correlation with general pathologic scores of PANSS(r=0.390，P=0.037).Conclusion　There are extensive cognitive impairment in first-episode schizophrenia patients，and the olanzapine monotherapy can partially improve the deficits of domain of speed of process and working memory.The cognitive function of first-episode schizophrenia patients is not related with clinical symptoms；the impairment of cognitive function is one of the symptoms of schizophrenia.

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更新日期/Last Update: 2016-05-05