本文選題：精神分裂癥 + 認(rèn)知功能障礙　； 參考：《昆明醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：既往研究認(rèn)為新型抗精神病藥物帕利哌酮緩釋片治療可以改善精神分裂癥患者精神癥狀和社會功能,然而改善的機(jī)制不明確,研究顯示,患者認(rèn)知功能損害是精神分裂癥的核心損害之一,認(rèn)知功能對病情評估及預(yù)后有極大的影響。本研究擬測評帕利哌酮緩釋片治療非急性期患者后其認(rèn)知功能是否改善,同時評價藥物治療前后患者癥狀及個人和社會功能的改善情況,最后評估患者的臨床癥狀及個人社會功能是否受認(rèn)知功能的影響。 方法：選取昆明醫(yī)科大學(xué)第一附屬醫(yī)院精神科門診及住院部2011年1月至2013年3月期間20例非急性期精神分裂癥患者,用帕利哌酮緩釋片治療24周。采用神經(jīng)心理測試以及認(rèn)知相關(guān)電位P300測試患者在帕利哌酮治療前后認(rèn)知功能變化,采用陽性與陰性癥狀量表(PANSS)和臨床總體印象量表(CGI-S)評定患者的精神癥狀,使用個人與社會功能量表(PSP)評定患者的社會功能,采用錐體外系副反應(yīng)量表(SAS)、不自主運(yùn)動量表(AIMS)和靜坐不能量表(BARS)監(jiān)測治療期間副反應(yīng)情況。 結(jié)果：1.經(jīng)過治療,非急性期精神分裂癥患者的一些認(rèn)知功能測試指標(biāo)在治療前后比較差異有統(tǒng)計(jì)學(xué)意義(p0.05),包括神經(jīng)心理測試結(jié)果中的霍普金斯詞語學(xué)習(xí)測試1試評分、空間廣度測試評分、視覺空間記憶測試總分和1試評分、迷宮測試評分、范疇流暢性測驗(yàn)評分、持續(xù)操作相同配對(CPT)：2-D測試評分、顏色連線測試2試評分及認(rèn)知相關(guān)電位P300測試中的P3波幅,這些項(xiàng)目的測試成績較治療前均改善；2.治療前后患者的癥狀及個人社會功能評分比較差異有統(tǒng)計(jì)學(xué)意義(p0.05),其中PANSS的各項(xiàng)評分、CGI-S評分明顯下降、PSP評分升高；3.神經(jīng)心理測試中的符號編碼、霍氏詞語測試3變化情況與PANSS評分變化有明顯相關(guān)性,顏色連線測試(包括1試、2試)、范疇流利測試、WSCT持續(xù)錯誤數(shù)以及WSCT非持續(xù)錯誤數(shù)變化情況與PSP評分變化情況有明顯相關(guān)性(p0.05),P300各項(xiàng)變化情況和癥狀及個人社會功能均沒有明顯相關(guān)性。 結(jié)論：1.非急性期精神分裂癥患者在帕利哌酮治療24周后認(rèn)知功能評分明顯改善；2.患者的個人社會功能改善、癥狀評分明顯好轉(zhuǎn)；3.治療后患者癥狀及個人社會功能可能隨認(rèn)知功能的提高而改善。
[Abstract]:Objective: previous studies have shown that a new antipsychotic sustained release tablet can improve mental symptoms and social function in schizophrenic patients, but the mechanism of improvement is not clear. Cognitive impairment is one of the core lesions of schizophrenia, and cognitive function has great influence on the evaluation and prognosis of the disease. The purpose of this study was to evaluate whether the cognitive function of patients with non-acute stage was improved after the treatment of Pariperidone sustained-release tablets, and to evaluate the improvement of patients' symptoms and personal and social functions before and after drug treatment. Finally, the clinical symptoms and individual social function of the patients were assessed to be affected by cognitive function. Methods: twenty patients with non-acute schizophrenia from January 2011 to March 2013 in psychiatric outpatient department and inpatient department of the first affiliated Hospital of Kunming Medical University were treated with Paripiperidone sustained release tablets for 24 weeks. The changes of cognitive function were measured by neuropsychological test and cognitive related potential (P300) before and after Paripiperone treatment. The mental symptoms were assessed by PANSS (positive and negative symptom scale) and CGI-S (General impression scale). The patients' social function was assessed by personal and social function scale (PSPs). The side effects were monitored by the extrapyramidal side effects scale (SASL), the involuntary motor scale (AIMS) and the sedentary incapacity scale (BARS). The result is 1: 1. After treatment, there were significant differences in some cognitive function test indexes of non-acute schizophrenic patients before and after treatment, including Hopkins word learning test 1 score in neuropsychological test results. Spatial span test score, visual spatial memory test total score and 1 test score, maze test score, category fluency test score, CPT: 2-D score, The test scores of color line test 2 and the P3 amplitude of cognitive related potential P300 test were improved by 2% compared with those before treatment. There were significant differences in the scores of symptoms and individual social function before and after treatment (P 0.05), in which the CGI-S scores of PANSS decreased significantly and the scores of PSP increased by 3%. The symbol coding in neuropsychological test and the change of Huo's word test 3 were significantly correlated with the change of PANSS score. Color line test (including 1 test and 2 test, category fluency test) WSCT persistent error number and WSCT nonpersistent error number change and PSP score changes were significantly correlated with the changes of P300 and P300 symptoms and individual social function. There was no significant correlation. Conclusion 1. The cognitive function score of non-acute schizophrenic patients improved significantly after 24 weeks of Pariperidone treatment. The individual social function of the patient was improved, and the symptom score was obviously improved by 3. 3%. Symptoms and individual social function may improve with the improvement of cognitive function after treatment.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.3

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本文編號：1905420