非急性期精神分裂症患者帕利哌酮治疗24周前后认知功能的对比研究

发布时间：2018-05-18 10:07

本文选题：精神分裂症 + 认知功能障碍　；参考：《昆明医科大学》2013年硕士论文

【摘要】：目的：既往研究认为新型抗精神病药物帕利哌酮缓释片治疗可以改善精神分裂症患者精神症状和社会功能,然而改善的机制不明确,研究显示,患者认知功能损害是精神分裂症的核心损害之一,认知功能对病情评估及预后有极大的影响。本研究拟测评帕利哌酮缓释片治疗非急性期患者后其认知功能是否改善,同时评价药物治疗前后患者症状及个人和社会功能的改善情况,最后评估患者的临床症状及个人社会功能是否受认知功能的影响。方法：选取昆明医科大学第一附属医院精神科门诊及住院部2011年1月至2013年3月期间20例非急性期精神分裂症患者,用帕利哌酮缓释片治疗24周。采用神经心理测试以及认知相关电位P300测试患者在帕利哌酮治疗前后认知功能变化,采用阳性与阴性症状量表(PANSS)和临床总体印象量表(CGI-S)评定患者的精神症状,使用个人与社会功能量表(PSP)评定患者的社会功能,采用锥体外系副反应量表(SAS)、不自主运动量表(AIMS)和静坐不能量表(BARS)监测治疗期间副反应情况。结果：1.经过治疗,非急性期精神分裂症患者的一些认知功能测试指标在治疗前后比较差异有统计学意义(p0.05),包括神经心理测试结果中的霍普金斯词语学习测试1试评分、空间广度测试评分、视觉空间记忆测试总分和1试评分、迷宫测试评分、范畴流畅性测验评分、持续操作相同配对(CPT)：2-D测试评分、颜色连线测试2试评分及认知相关电位P300测试中的P3波幅,这些项目的测试成绩较治疗前均改善；2.治疗前后患者的症状及个人社会功能评分比较差异有统计学意义(p0.05),其中PANSS的各项评分、CGI-S评分明显下降、PSP评分升高；3.神经心理测试中的符号编码、霍氏词语测试3变化情况与PANSS评分变化有明显相关性,颜色连线测试(包括1试、2试)、范畴流利测试、WSCT持续错误数以及WSCT非持续错误数变化情况与PSP评分变化情况有明显相关性(p0.05),P300各项变化情况和症状及个人社会功能均没有明显相关性。结论：1.非急性期精神分裂症患者在帕利哌酮治疗24周后认知功能评分明显改善；2.患者的个人社会功能改善、症状评分明显好转；3.治疗后患者症状及个人社会功能可能随认知功能的提高而改善。
[Abstract]:Objective: previous studies have shown that a new antipsychotic sustained release tablet can improve mental symptoms and social function in schizophrenic patients, but the mechanism of improvement is not clear. Cognitive impairment is one of the core lesions of schizophrenia, and cognitive function has great influence on the evaluation and prognosis of the disease. The purpose of this study was to evaluate whether the cognitive function of patients with non-acute stage was improved after the treatment of Pariperidone sustained-release tablets, and to evaluate the improvement of patients' symptoms and personal and social functions before and after drug treatment. Finally, the clinical symptoms and individual social function of the patients were assessed to be affected by cognitive function. Methods: twenty patients with non-acute schizophrenia from January 2011 to March 2013 in psychiatric outpatient department and inpatient department of the first affiliated Hospital of Kunming Medical University were treated with Paripiperidone sustained release tablets for 24 weeks. The changes of cognitive function were measured by neuropsychological test and cognitive related potential (P300) before and after Paripiperone treatment. The mental symptoms were assessed by PANSS (positive and negative symptom scale) and CGI-S (General impression scale). The patients' social function was assessed by personal and social function scale (PSPs). The side effects were monitored by the extrapyramidal side effects scale (SASL), the involuntary motor scale (AIMS) and the sedentary incapacity scale (BARS). The result is 1: 1. After treatment, there were significant differences in some cognitive function test indexes of non-acute schizophrenic patients before and after treatment, including Hopkins word learning test 1 score in neuropsychological test results. Spatial span test score, visual spatial memory test total score and 1 test score, maze test score, category fluency test score, CPT: 2-D score, The test scores of color line test 2 and the P3 amplitude of cognitive related potential P300 test were improved by 2% compared with those before treatment. There were significant differences in the scores of symptoms and individual social function before and after treatment (P 0.05), in which the CGI-S scores of PANSS decreased significantly and the scores of PSP increased by 3%. The symbol coding in neuropsychological test and the change of Huo's word test 3 were significantly correlated with the change of PANSS score. Color line test (including 1 test and 2 test, category fluency test) WSCT persistent error number and WSCT nonpersistent error number change and PSP score changes were significantly correlated with the changes of P300 and P300 symptoms and individual social function. There was no significant correlation. Conclusion 1. The cognitive function score of non-acute schizophrenic patients improved significantly after 24 weeks of Pariperidone treatment. The individual social function of the patient was improved, and the symptom score was obviously improved by 3. 3%. Symptoms and individual social function may improve with the improvement of cognitive function after treatment.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.3

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