CAJ | 학술논문

目的了解奥氮平和喹硫平对慢性精神分裂症患者认知功能的改善情况,并比较二者对患者认知功能的改善程度是否具有差异性.方法 87例经典抗精神病药物治疗疗效不显著或不能耐受不良反应的慢性精神分裂症患者随机分配替换为奥氮平及喹硫平治疗,分别在入组前、12周和6个月时进行精神症状的评定,包括PANSS、CGI、HAMD-17量表,以及认知功能的测定,包括言语学习、记忆、注意、执行功能、精神运动.结果 78例患者完成12周的治疗(奥氮平=38,喹硫平=40),65例临床稳定的患者(PANSS量表≤60分或PANSS减分率≥50%)完成6个月的治疗(奥氮平=32,喹硫平=33).与基线比较,这些患者的精神症状在换药治疗6个月时均得到显著改善,认知功能在12周和6个月时也都得到显著改善.认知功能总体的改善在12周时最显著,6个月时的改善程度与12周时相当.具体分析单个认知功能的改善时发现12周时喹硫平组在言语流畅性、言语记忆、CPT反应时间方面较奥氮平组有显著性差异,而6个月时两者之间无显著差异.患者认知功能的改善和精神症状的改善之间的相关性较小.结论奥氮平和喹硫平均可改善慢性精神分裂症的认知功能,且两者改善的总体程度相当,但在具体的单个认知层面上稍有差异.
목적 료해오담평화규류평대만성정신분렬증환자인지공능적개선정황,병비교이자대환자인지공능적개선정도시부구유차이성.방법 87례경전항정신병약물치료료효불현저혹불능내수불량반응적만성정신분렬증환자수궤분배체환위오담평급규류평치료,분별재입조전、12주화6개월시진행정신증상적평정,포괄PANSS、CGI、HAMD-17량표,이급인지공능적측정,포괄언어학습、기억、주의、집행공능、정신운동.결과 78례환자완성12주적치료(오담평=38,규류평=40),65례림상은정적환자(PANSS량표≤60분혹PANSS감분솔≥50%)완성6개월적치료(오담평=32,규류평=33).여기선비교,저사환자적정신증상재환약치료6개월시균득도현저개선,인지공능재12주화6개월시야도득도현저개선.인지공능총체적개선재12주시최현저,6개월시적개선정도여12주시상당.구체분석단개인지공능적개선시발현12주시규류평조재언어류창성、언어기억、CPT반응시간방면교오담평조유현저성차이,이6개월시량자지간무현저차이.환자인지공능적개선화정신증상적개선지간적상관성교소.결론 오담평화규류평균가개선만성정신분렬증적인지공능,차량자개선적총체정도상당,단재구체적단개인지층면상초유차이.
Objective To compare the effects of olanzapine and quetiapine on cognitive function in patients with chronic schizophrenia. Methods Eight-seven patients with chronic schizophrenia who had either iailed to show sufficient clinical improvement or suffered from side effects with conventional antipsychotics were ran-domly divided into olanzapine group or quetiapine group. They were assessed at the baseline, the end of 12th week and the 6th month with PANSS , HAMD-17, TESS and cognitive function tests. Results There were 78 patients completed the 12-week treatment, afterwards, 65 of them who had obtained a stable clinical perform-ance (PANSS total score≤60 or PANSS reduced rate≥50%) fulfilled the 6-month treatment. Compared with the baseline, the psychotic symptoms of all these patients had significant improvement after 6 months, the cog-nitive function also had significant improvement at the ends of 12th week and the 6th month after treatment.The improvement of verbal fluency, verbal memory and the reaction time to CPT were significantly different between two groups at the end of 12-week after treatment, however, no significant differences were found be-tween two groups at the endpoint of the 6-month treatment. The improvement of cognitive function in patients showed no significant relation with the impronement of psychotic symptoms. Conclusion Both olanzapine and quetiapine can improve cognitive function of chronic schizophrenic patients, with difference in the aspect of indi-vidual neurocognitive measure.