利培酮对精神分裂症合并糖尿病患者的疗效及认知功能的影响

范银莹+刘家洪+高智勇+潘安乐+邵登衡+朱程+郑克++吴兢勤+惠李

[摘要] 目的 观察利培酮对精神分裂症合并糖尿病患者的疗效及认知功能的影响。 方法 选择我院2010年1月～2015年1月期间76例精神分裂症合并糖尿病患者，随机分为两组，对照组38例患者予常规治疗，观察组38例在常规治疗的基础上加用利培酮口服治疗，两组均治疗8周。疗程结束后，评价两组治疗的临床疗效，同时比较两组患者治疗前后WAIS-RC认知功能评分的变化情况。 结果 治疗后，观察组的总有效率为97.37%，显著高于对照组的73.68%，差异有统计学意义（P<0.05）。治疗前，两组患者的WAIS-RC评分比较，差异无统计学意义（P>0.05），治疗8周后，观察组与对照组患者的WAIS-RC评分分别为（91.6±12.4）分、（82.5±13.7）分，均显著高于治疗前，且观察组患者治疗后的WAIS-RC评分显著高于对照组（P<0.05）。 结论 精神分裂症合并糖尿病患者应用利培酮治疗可以提高临床疗效，显著改善患者的认知功能，从而有利于促进患者疾病的恢复。

[关键词] 精神分裂症；糖尿病；利培酮；认知功能

[中图分类号] R749.3 [文献标识码] B [文章编号] 1673-9701（2016）23-0078-04

[Abstract] Objective To observe the effect of risperidone on efficacy and cognitive function in patients with schizophrenia combined with diabetes. Methods A total of 76 patients with schizophrenia combined with diabetes treated in our hospital from January 2010 to January 2015 were selected and randomly divided into two groups. 38 patients in control group were given conventional therapy， and 38 patients in observation group were given conventional therapy plus oral risperidone， both for 8 weeks. After the period of treatment， clinical effects were evaluated and changes of WAIS-RC cognitive function scores before and after treatment were compared between the two groups. Results After the treatment， the overall response rate in the observation group （97.37%） was significantly higher than that in the control group （73.68%， P<0.05）. The difference of WAIS-RC scores in the two groups was not significant before the treatment（P>0.05）. After the 8 weeks of treatment， the WAIS-RC scores in the observation group（91.6±12.4） and in the control group（82.5±13.7） were significantly higher than those before the treatment， and the post-treatment scores in the observation group were significantly higher than those in the control group（P<0.05）. Conclusion Risperidone can significantly improve the clinical efficacy and cognitive function in patients with schizophrenia combined with diabetes， and can promote recovery of patients.

[Key words] Schizophrenia； Diabetes； Risperidone； Cognitive function

精神分裂症（schizophrenia，SCZ）是精神科的常见病、多发病，临床主要表现为个性改变、思维、情感分裂、精神活动、环境不协调，其中认知功能损害是精神分裂症患者常见的核心症状[1]。近年来研究发现，精神分裂症患者由于受遗传、环境及抗精神病药物等因素的间接作用，导致合并糖尿病的发病率逐年增加。而研究发现，糖尿病是导致认知功能障碍的独立危险因素，认知功能受损可能与患者血糖控制不理想有关，高血糖可能会直接损伤患者的认知功能[2]。对糖尿病的诸多研究表明，糖尿病患者往往存在不同程度的注意分散、记忆减退、思维迟缓、分类概括能力降低等认知功能障碍，且糖尿病患者与普通人群相比存在明显的认知缺陷[3]。……