【摘要】 目的 探讨齐拉西酮、奥氮平和氯丙嗪三种抗精神病药物治疗首发精神分裂症疗效及对患者认知功能的影响。方法将135例精神分裂症患者分为3组,齐拉西酮组45例、奥氮平组45例和氯丙嗪组45例。治疗前、治疗第8周末采用阳性与阴性症状量表评定患者的疗效,运用威斯康星卡片分类测验、持续操作功能测验、韦氏成人智力测验和言语流畅评定患者的认知功能。结果3组患者在治疗8周末阳性与阴性症状量表阳性症状,总分分值较治疗前显著下降(P<0.01);在威斯康星卡片分类测验的持续错误数及完成分类数测试中,齐拉西酮组和奥氮平组在治疗8周较治疗前有差异(P<0.05或0.01);齐拉西酮组和奥氮平组在韦氏成人智力测验的顺背数和再认测试中,治疗8周末与治疗前相比有差异(P<0.05或0.01),而在倒背数及图片测试中治疗前后相比无差异(P>0.05);齐拉西酮组和奥氮平组的言语流畅测试在治疗第8周末与治疗前比较均有显著提高(P<0.01);而氯丙嗪组治疗8周末与治疗前比较均无差异性(P>0.05)。结论 齐拉西酮和奥氮平均是安全有效的新型抗精神病药物,能有效缓解首发精神分裂症的临床症状和改善其认知功能,在改善认知方面优于传统抗精神病药物氯丙嗪。更多还原

【Abstract】 Objective To explore the efficacies of ziprasidone,olanzapine and chlorpromazine in the treatment of first-episode schizophrenia and their influences on cognitive function.Methods A total of 135 schizophrenics were treated with ziprasidone（n = 45）,olanzapine（n=45） or chlorpromazine（72 =45）.Efficacies were assessed with the Positive and Negative Syndrome Scale（PANSS）before treatment and at the end of the 8^th week treatment and cognitive functions with the Wisconsin Card Sorting Test（WCST）,Continue Performance Test（CPT）,Wechsler Adult Intelligence Tests（WAIS） and Verbal Fluency Test（VFT）.Results At the end of the 8^th week the positive symptom and total scores of the 3 groups of the PANSS lowered more significantly compared with pretreatment（P<0.01）;there were pre-and post-treatment differences in the numbers of perseverative errors and categories achieved in ziprasidone and olanzapine group（P<0.05 or 0.01）;there were pre-and post-treatment differences in digit forward and recognition of the WCST in ziprasidone and olanzapine group（P<0.05 or 0.01） and no in digit backward and card test（P>0.05）;the VFT scores heightened more significantly in ziprasidone and olanzapine group at the end of the 8^th week compared with pretreatment（P<0.01）;the VFT scores had no pre-and posttreatment differences in chloropromazine group（P>0.05）.Conclusion Both ziprasidone and olanzapine are safe and effective novel antipsychotic drugs,could effectively alleviate the clinical symptoms of first-episode schizophrenia and improve cognitive functions,and have an advantage in improving cognitive functions over chlorpromazine.更多还原