奥氮平联合奥拉西坦治疗老年精神分裂患者认知功能障碍的对照研究

Comparative Study of Olanzapine Combined with Oxiracetam in the Treatment of Cognitive Impairment in Elderly Schizophrenic Patients

关键词:  奥氮平  奥拉西坦  老年精神分裂症  认知功能障碍

Key words:  olanzapine  oxiracetam  elderly schizophrenia  cognitive dysfunction

摘要:

目的 探讨奥氮平联用奥拉西坦对老年精神分裂症患者认知功能障碍的改善作用。方法 随机选取2017年8月-2018年3月新乡医学院第二附属医院收治的老年精神分裂症伴认知功能障碍的患者60例进行前瞻性研究，随机分为单用奥氮平治疗组（单用组），奥氮平联合奥拉西坦治疗组（联用组），每组30例。分别于实验前，治疗后4，8周对2组患者采用阳性和阴性症状量表（positive and negative syndrome scale，PANSS）进行病情严重程度评价，采用韦斯数字广度测验（digital span test，DS）、威斯康星卡片分类测试（Wisconsin card sorting tes，WCST）进行认知功能评价；并于4周末上午空腹抽血，监测肝功和血脂变化。同时招募30名60~75岁健康受试者为正常组，进行上述评价。结果 单用组和联用组PANSS各项评分，治疗4周较治疗前降低（P<0.05）、治疗8周较治疗4周降低（P<0.05）。单用组和联用组的DS和WCST各项评分治疗4周较治疗前均有明显改善（P<0.05），且联用组DS的正背项和总分、WCST的正确应答数明显高于单用组（P<0.05）；2组的DS各项评分治疗8周较治疗4周均有明显改善（P<0.05），且联用组较单用组改善明显（P<0.05），WCST中正确应答数、错误应答数和完成分类数有明显改善（P<0.05），且联用组较单用组改善明显（P<0.05）。4周末2组ALT、AST、TC和TG均较治疗前升高（P<0.05），但2组间无显著差异（P>0.05）。结论 奥氮平联合奥拉西坦可有效改善老年精神分裂症患者的认知功能障碍，且疗效优于单用奥氮平。

Abstract:

OBJECTIVE To explore the effect of olanzapine combined with oxiracetam on cognitive dysfunction in elderly schizophrenics patients. METHODS The 60 elderly patients with schizophrenia and cognitive impairment admitted to a psychiatric hospital from August 2017 to March 2018 were randomly selected for prospective study, and were randomly divided into the olanzapine treatment group (single group) and olanzapine combined with oxiracetam treatment group (combination group), 30 cases in each group. The severity of the two groups of patients was evaluated by positive and negative symptom scale (PANSS) before the experiment, 4 weeks after the treatment, and 8 weeks after the treatment, respectively. The cognitive function was evaluated by Weiss digital span test (DS) and Wisconsin card classification test (WCST). Fasting blood was taken in the morning after 4 weeks, and liver function and lipid changes were monitored. Thirty healthy subjects aged 60 to 75 years old were recruited as the control group and evaluated above. RESULTS PANSS scores of the single group and the combination group were lower at 4 weeks than before treatment (P<0.05), and lower at 8 weeks than at 4 weeks after treatment (P<0.05). The scores of DS and WCST in the single group and the combination group were significantly improved 4 weeks after treatment (P<0.05), and the positive dorsal term and total score of DS and the correct response number of WCST were significantly higher in the combination group than in the single group (P<0.05). All DS scores of the two groups were significantly improved at 8 weeks of treatment compared with 4 weeks of treatment (P<0.05), and the number of correct response, wrong response and completed classification in WCST was significantly improved in the combination group compared with the single group (P<0.05). After 4 weeks, ALT, AST, TC and TG in both groups were higher than before treatment (P<0.05), but there was no significant difference between the two groups (P>0.05). CONCLUSION Olanzapine combined with oxiracetam can effectively improve cognitive dysfunction in elderly patients with schizophrenia, and the effect is better than that of olanzapine alone.