帕利哌酮缓释片联合阿立哌唑对精神分裂症精神病性症状、认知功能和催乳素的影响

黄锦; 朱丞

doi:10.16766/j.cnki.issn.1674-4152.002680

帕利哌酮缓释片联合阿立哌唑对精神分裂症精神病性症状、认知功能和催乳素的影响

doi: 10.16766/j.cnki.issn.1674-4152.002680

黄锦^1, ,,
朱丞²

1.
建德市第四人民医院精神科二病区，浙江杭州 311612
2.
浙江大学附属精神卫生中心，杭州市第七人民医院精神四科，浙江杭州 310013

基金项目:

浙江省卫生健康科技计划项目 2022517135

详细信息

通讯作者:
黄锦, E-mail: hjjdsy2020@163.com

中图分类号: R749.3R971.41
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出版历程
- 收稿日期: 2022-03-22
- 网络出版日期: 2022-11-30

Effects of paliperidone sustained-release tablets combined with aripiprazole on psychotic symptoms, cognitive function and prolactin in schizophrenia

HUANG Jin^{1
, ,},
ZHU Cheng²

1.
Second Department of Psychiatry, the Fourth People' s Hospital of Jiande, Hangzhou, Zhejiang 311612, China

摘要

摘要: 目的探讨帕利哌酮缓释片、阿立哌唑联合治疗对精神分裂症精神病性症状和认知功能的改善作用及对催乳素的影响。方法 2019年9月—2021年9月建德市第四人民医院招募精神分裂症患者96例，依据随机数字表法分为干预组(48例)和对照组(48例)。干预组接受帕利哌酮缓释片联合阿立哌唑10 mg/d治疗，对照组给予帕利哌酮缓释片治疗，经8周治疗，观察2组阳性和阴性症状量表(PANSS)评分、MATRICS共识认知成套测验(MCCB)评分和催乳素变化。结果治疗后，2组PANSS、MCCB评分均较前改善(均P＜0.001)，催乳素水平升高(P＜0.001)；干预组PANSS评分[干预组(65.06±10.47)分，对照组(70.17±6.36)分，P=0.005]、信息处理速度[干预组(55.06±6.48)分，对照组(49.85±4.76)分，P＜0.001]、注意警觉[干预组(54.33±9.37)分，对照组(48.94±5.31)分，P=0.001]、工作记忆[干预组(50.33±5.65)分，对照组(45.96±4.65)分，P＜0.001]、催乳素水平[干预组(46.52±2.59)ng/mL，对照组(65.63±8.32)ng/mL，P＜0.001]均优于对照组。治疗后2组词语学习、视觉学习、推理和问题解决能力和社会认知差异无统计学意义(均P＞0.05)。结论帕利哌酮缓释片联合阿立哌唑可有效改善精神分裂症精神病性症状、认知功能，阿立哌唑可降低帕利哌酮缓释片引起的高催乳素水平。
- 精神分裂症 /
- 帕利哌酮 /
- 阿立哌唑 /
- 认知功能 /
- 催乳素
Abstract: Objective To investigate alleviation of psychotic symptoms and cognitive function of schizophrenia and the effect of prolactin in the combined treatment of paliperidone sustained-release tablets and aripiprazole. Methods Ninety-six patients with schizophrenia were recruited at the Fourth People' s Hospital of Jiande from September 2019 to September 2021 and randomly divided into intervention group (n=48) and control group (n=48) with the random number table method. The patients in the intervention group received paliperidone sustained-release tablets combined with aripiprazole at 10 mg/day, and the control group received paliperidone sustained-release tablets. Changes in positive and negative syndrome scale (PANSS), MATRICS consensus cognitive battery (MCCB) and prolactin were observed in both groups after 8 weeks of treatment. Results After treatment, the PANSS and MCCB scores improved (all P < 0.001) and prolactin levels increased (P < 0.001) in both groups. The scores of PANSS [intervention group, (65.06±10.47) points, control group, (70.17±6.36) points, P=0.005], information processing speed [intervention group, (55.06±6.48) points, control group, (49.85±4.76) points, P < 0.001], attention/vigilance [intervention group, (54.33±9.37) points, control group, (48.94±5.31) points, P=0.001], working memory [intervention group, (50.33±5.65) points, control group, (45.96±4.65) points, P < 0.001], prolactin levels [intervention group, (46.52±2.59) ng/mL, control group, (65.63±8.32) ng/mL, P < 0.001] in the intervention group were better than the control group. No statistically significant difference in word learning, visual learning, reasoning and problem-solving ability and social cognition was found between the two groups after treatment (all P>0.05). Conclusion Paliperidone sustained-release tablets combined with aripiprazole can effectively alleviate psychotic symptoms and cognitive function in schizophrenia. Aripiprazole can reduce the hyperprolactin level caused by paliperidone extended-release tablets.
- Schizophrenia /
- Paliperidone /
- Aripiprazole /
- Cognitive function /
- Prolactin

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表 1 2组精神分裂症患者一般资料比较

Table 1. Comparison of the general characteristics in two groups of patients with schizophrenia

组别	例数	年龄 (x±s，岁)	性别 (男/女，例)	受教育年限 (x±s，年)	病程 (x±s，年)
干预组	48	38.17±10.69	27/21	12.15±2.54	17.85±10.15
对照组	48	38.85±10.51	30/18	11.85±2.80	16.77±8.23
统计量		0.318^a	0.389^b	0.535^a	0.574^a
P值		0.751	0.533	0.594	0.567
注：^a为t值，^b为χ²值。

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表 2 2组精神分裂症患者治疗前后PANSS评分及催乳素水平比较(x±s)

Table 2. Comparison of the PANSS scores and prolactin level in two groups of patients with schizophrenia before and after treatment(x±s)

组别	例数	PANSS(分)		催乳素(ng/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后
干预组	48	99.06±14.15	65.06±10.47^a	29.13±6.96	46.52±2.59^a
对照组	48	99.88±15.54	70.17±6.36^a	30.69±6.45	65.63±8.32^a
t值		0.268	2.887	1.141	15.184
P值		0.789	0.005	0.257	< 0.001
注：与同组治疗前比较，^aP＜0.001。

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表 3 2组精神分裂症患者治疗前后MCCB评分比较(x±s，分)

Table 3. Comparison of the MCCB scores in two groups of patients with schizophrenia before and after treatment(x±s, points)

组别	例数	信息处理速度		注意警觉				工作记忆
组别	例数	治疗前	治疗后	治疗前		治疗后		治疗前	治疗后
干预组	48	40.67±4.58	55.06±6.48^a	43.15±7.71		54.33±9.37^a		38.13±6.90	50.33±5.65^a
对照组	48	41.13±4.75	49.85±4.76^a	42.56±5.31		48.94±5.31^a		38.71±4.91	45.96±4.65^a
t值		0.481	4.488	0.432		3.472		0.477	4.144
P值		0.632	< 0.001	0.667		0.001		0.634	< 0.001

组别	例数	词语学习		视觉学习		推理和问题解决能力		社会认知
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
干预组	48	31.40±5.63	49.56±6.31^a	45.77±4.42	55.67±8.55^a	43.60±3.77	56.77±6.93^a	37.23±3.28	52.44±6.16^a
对照组	48	32.65±5.00	48.85±6.49^a	47.25±4.22	54.77±8.42^a	43.19±3.69	54.42±6.79^a	36.69±3.35	52.60±5.80^a
t值		1.149	0.542	1.678	0.517	0.547	1.681	0.801	0.136
P值		0.253	0.589	0.097	0.606	0.585	0.096	0.425	0.892
注：与同组治疗前比较，^aP＜0.001。

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