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| 阿立哌唑与利培酮对慢性精神分裂症患者症状改善的疗效差异 |
| Difference between aripiprazole and risperidone on symptom improvement in chronic schizophrenia patients |
| 投稿时间：2024-08-02 修订日期：2025-02-12 |
| DOI： |
| 中文关键词: 慢性精神分裂症 阿哌利唑 利培酮 前脉冲抑制 症状改善 |
| 英文关键词:Chronic schizophrenia Aripiprazole Risperidone Pre-pulse inhibition Symptom improvement |
| 基金项目:2021年度阜阳市卫生健康委科研课题（项目名称：精神分裂症伴代谢障碍的认知功能研究，项目编号：FY2021-147) |
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| 中文摘要: |
| 【】背景 非典型抗精神病药物(AAPS)在慢性精神分裂症患者中应用广泛,常用药物包括阿立哌唑、利培酮等,两种药物对精神分裂症患者分别通过不同的作用机制进行症状的改善,但两种药物的相对疗效需要进一步探索。目的 探讨阿立哌唑、利培酮对慢性精神分裂症患者的症状改善情况,以及对患者前脉冲抑制(PPI)、认知功能及神经营养因子的影响,为优化慢性精神分裂症患者药物治疗提供参考。方法:选取2021年3月-2023年3月阜阳市第三人民医院收治的符合《国际疾病分类(第10版)》(ICD-10)慢性精神分裂症诊断标准的86例患者作为研究对象,采用随机数字表法分为两组各43例,分别接受为期3个月的阿立哌唑(起始剂量为5mg/d,一周后逐渐加量,最高为25mg/d)和利培酮(起始剂量为0.5mg/d,一周后逐渐加量,最高为2mg/d)治疗。在治疗前及治疗3个月后采用阳性和阴性症状量表(PANSS)评价两组患者症状改善情况,采用强弱刺激结合的被动注意PPI检测范式检测两组患者PPI相关指标,采用威斯康星卡片分类测验(WCST)、逻辑记忆测验、木块图测验分别对额叶、颞叶、顶叶认知功能进行评价,分别检测患者血清脑源性神经因子(BDNF)、胶质纤维酸性蛋白因子(GFAP)、神经生长因子(NGF)水平评价神经营养因子。结果 两组PANSS量表在治疗前后差异有统计学意义(P＜0.05),协方差分析差异无统计学意义(F=0.621、0.815、0.743、0.752,P＞0.05)。两组PPI相关指标治疗前后比较差异无统计学意义(P＞0.05),协方差分析差异无统计学意义(F=0.174、0.000、0.183、0.171、0.000,P＞0.05)。两组认知功能各项治疗前后差异有统计学意义(P＜0.05),协方差分析提示在治疗后阿立哌唑组与利培酮组比较除额叶总测验次数(F=0.512,P＞0.05)外差异均有统计学意义(F=3.737、4.892、5.130、4.621、5.370、3.926,P＜0.05)。两组神经营养因子BDNF、GFAP、NGF治疗前后差异有统计学意义(P＜0.05),协方差分析提示阿立哌唑组与利培酮在治疗后差异有统计学意义(F=4.414、6.319、3.781,P＜0.05)。结论 利培酮与阿立哌唑均可改善慢性精神分裂症患者症状、认知功能以及神经营养因子水平,但两种药物对于PPI缺陷的改善情况仍有待提升,后者对于患者认知功能与神经营养因子水平改善效果更显著。 |
| 英文摘要: |
| 【】 Background:Atypical antipsychotics (AAPS) have been widely used in patients with chronic schizophrenia in recent years. Commonly used drugs include aripiprazole and risperidone. The two drugs improve symptoms in patients with schizophrenia through different mechanisms of action, but further exploration is needed to determine which drug is more effective in improving symptoms in which aspect.Objective: To investigate the effects of aripiprazole and risperidone on prepulse inhibition (PPI), cognitive function and neurotrophic factors in patients with chronic schizophrenia, compare the improvement of symptoms of aripiprazole and risperidone in patients with chronic schizophrenia, and provide effective treatment drugs for patients with chronic schizophrenia.Methods: 86 patients with chronic schizophrenia admitted to the Psychiatry Department of the Third People"s Hospital of Fuyang City from March 2021 to March 2023 and met the diagnostic criteria of International Classification of Diseases (10th edition) (ICD-10) were selected as the research objects. They were randomly divided into aripiprazole group (starting dose 5mg/d, gradually increasing after one week, up to 25mg/d) and risperidone group (starting dose 0.5mg/d, gradually increasing after one week, up to 2mg/d) for 3 months, with 43 cases in each group. The Post-Treatment Positive and Negative Symptom Scale (PANSS) was used to evaluate the symptom improvement of patients in the two groups before treatment and after 3 months of treatment, and PPI related indicators were detected by passive attention PPI detection paradigm combining strong and weak stimuli. The cognitive functions of frontal, temporal and parietal lobes were evaluated by Wisconsin Card Sorting Test (WCST), logic memory test and wood block map test, and the levels of serum brain-derived neurofactor (BDNF), glial fibrillary acidic protein factor (GFAP) and nerve growth factor (NGF) were detected to evaluate neurotrophic factors..Results: There was a statistically significant difference (P<0.05) between the two groups of PANSS scales before and after treatment, while there was no statistically significant difference in covariance analysis (F=0.621, 0.815, 0.743, 0.752, P>0.05). There was no statistically significant difference in PPI related indicators between the two groups before and after treatment (P>0.05), and no statistically significant difference in covariance analysis (F=0.174, 0.000, 0.183, 0.171, 0.000, P>0.05). There was a statistically significant difference in cognitive function between the two groups before and after treatment (P<0.05), and covariance analysis showed that there was no statistically significant difference between the aripiprazole group and the risperidone group after treatment except for the total number of frontal lobe tests (F=0.512, P>0.05) (F=3.737, P>0.05). 4.892, 5.130, 4.621, 5.370, 3.926, P<0.05). Two groups of neurotrophic factors BDNF There was a statistically significant difference in GFAP and NGF before and after treatment (P<0.05), and covariance analysis showed that there was a statistically significant difference between the aripiprazole group and risperidone group after treatment (F=4.414, 6.319, 3.781, P<0.05).Conclusion: Both risperidone and aripiprazole can significantly improve symptoms cognitive function, and neurotrophic factor levels in patients with chronic schizophrenia. However, the improvement of PPI deficiency by both drugs still needs to be improved, with the latter showing a more significant improvement in patients" cognitive function and neurotrophic factor levels. |
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