CAJ | 학술논문

目的：比较阿立哌唑与利培酮对首发精神分裂症患者认知功能、执行功能、生存质量及临床疗效的影响。方法：将133例符合诊断标准的精神分裂症患者随机分为观察组和对照组，分别予以阿立哌唑或利培酮治疗，疗程为8周。治疗前后认知功能评价采用韦氏记忆量表（ WMS-RC ），执行功能评价采用威斯康星卡片分类测验（ WCST ），生存质量评价采用世界卫生组织生存质量测定量表简表（WHOQOL-BREF），疗效和不良反应评价采用阳性和阴性症状量表（PANSS）或副反应量表（TESS）及实验室检查。结果：治疗8周后，2组患者在认知功能、执行功能和生存质量方面均有明显改善（ P＜0.05），但观察组患者对言语智商、持续错误数方面及生理领域的改善程度优于对照组。2组PANSS总分及各项因子分与治疗前比较均有显著性差异（ P＜0.05）。组间比较，治疗8周末观察组阴性症状因子分与对照组比较有显著性差异（ P＜0.05）。观察组和对照组的有效率分别为92.77％和87.50％，2组疗效经比较无显著性差异（χ2＝1.28，P＞0.05），但阿立哌唑组对阴性症状的改善要优于利培酮组，且观察组和对照组不良反应发生率分别为37.65％和64.32％，经比较有显著性差异（ P＜0.05）。结论：阿立哌唑治疗首发精神分裂症安全有效，能明显改善患者的认知功能、执行功能、生活质量。
목적：비교아립고서여리배동대수발정신분렬증환자인지공능、집행공능、생존질량급림상료효적영향。방법：장133례부합진단표준적정신분렬증환자수궤분위관찰조화대조조，분별여이아립고서혹리배동치료，료정위8주。치료전후인지공능평개채용위씨기억량표（ WMS-RC ），집행공능평개채용위사강성잡편분류측험（ WCST ），생존질량평개채용세계위생조직생존질량측정량표간표（WHOQOL-BREF），료효화불량반응평개채용양성화음성증상량표（PANSS）혹부반응량표（TESS）급실험실검사。결과：치료8주후，2조환자재인지공능、집행공능화생존질량방면균유명현개선（ P＜0.05），단관찰조환자대언어지상、지속착오수방면급생리영역적개선정도우우대조조。2조PANSS총분급각항인자분여치료전비교균유현저성차이（ P＜0.05）。조간비교，치료8주말관찰조음성증상인자분여대조조비교유현저성차이（ P＜0.05）。관찰조화대조조적유효솔분별위92.77％화87.50％，2조료효경비교무현저성차이（χ2＝1.28，P＞0.05），단아립고서조대음성증상적개선요우우리배동조，차관찰조화대조조불량반응발생솔분별위37.65％화64.32％，경비교유현저성차이（ P＜0.05）。결론：아립고서치료수발정신분렬증안전유효，능명현개선환자적인지공능、집행공능、생활질량。
Objective:To compare with the effects of aripiprazole and risperidone on cognitive function , execution , quality of life and clinical function in first -episode schizophrenia .Methods:133 patients with schizophrenia accorded with the diagnostic criteria were randomly divided into study group which were treated with aripiprazole and control group which were treated with risperidone ,and treated for 8 weeks.Evaluation of cognitive function before and after treatment were with Wechsler Memory Scale ( WMS -RC );executive function were assessed by Wisconsin Card Sorting Test ( WCST );evaluation of the quality of life were with WHOQOL-BREF;the effect and adverse reaction were evaluated with the positive and negative symptom scale ( PANSS) and side effects scale ( TESS) and laboratory examination .Results:Recognition function , executive function and quality of life were significantly improved After 8 weeks in the study group and the control group of schizophrenia ( P<0.05);but verbal IQ ,number of perseverative errors and physiological field in the study group is better than that in control group .There were statistically significant for comparing with PANSS total scores and the factor scores before and after treating in all groups ( P<0.05);There was statistically significant for comparing with negative symptom factor scores between the two groups ( P<0.05 ) .The effective rate in study group and the control group were 92.77%and 87.50%respectively , there was no significant difference (χ2 =1.28 ,P>0.05 );the improvement of negative symptoms in aripiprazole group was superior to risperidone group, and the adverse reaction rate were 37.65% and 64.32% respectively with statistical significance difference ( P <0.05 ) .Conclusion:aripiprazole in the treatment of first episode schizophrenia is safe and effective,can significantly improve the cognition and executive function ,and quality of life.