万晓娜　李桂臣

[摘要] 目的 分析齐拉西酮治疗精神分裂症伴抑郁症状患者的临床疗效。 方法 将70例精神分裂症伴抑郁症状患者采用双盲法分为对照组（利培酮）和观察组（齐拉西酮），以治疗前、治疗2周、4周、8周后为观察时间点，记录阴性和阳性症状量表（PANSS）总分及减分率；记录卡尔加里精神分裂症抑郁量表（CDSS）分值、不良反应发生率；评估治疗前及治疗8周后患者的执行功能。 结果 治疗2、4、8周后观察组PANSS总分较对照组低，治疗4周后减分率较对照组高（P<0.05）；治疗2周及4周后观察组CDSS分值明显降低且低于对照组（P<0.05）；治疗8周后观察组随机错误次数显著低于对照组（P<0.05）；观察组发生率为42.86%，低于对照组的74.29%（P<0.05）。 结论 齐拉西酮和利培酮均能有效治疗精神分裂症，前者近期效果更好；齐拉西酮治疗抑郁效果更优且能改善患者执行功能，用药安全性更好。

[关键词] 齐拉西酮；精神分裂症；抑郁；执行功能

[中图分类号] R749.3 [文献标识码] B [文章编号] 1673-9701（2017）06-0100-03

[Abstract] Objective To analyze the clinical efficacy of ziprasidone in the treatment of schizophrenia with depressive symptoms. Methods 70 cases of schizophrenia complicated with depression were divided into control group （risperidone） and observation group（ziprasidone） by double-blind method. The total score and reduction rate of negative and positive symptoms scale（PANSS） were recorded before treatment， 2 weeks， 4 weeks and 8 weeks after treatment. Calgary Schizophrenia Depression Scale （CDSS） score， the incidence of adverse reactions were recorded. The executive function in patients were assessed before and 8 weeks after treatment. Results The total score of PANSS in the observation group was lower than that in the control group at 2， 4， 8 weeks after treatment， and the rate of reduction was higher compared with the control group at 4 weeks after treatment. At 2 weeks and 4 weeks after treatment， the CDSS score of the observation group was significantly lower than that of the control group（P<0.05）. The number of random errors in the observation group was significantly lower than that in the control group（P<0.05） at 8 weeks after treatment. The incidence of random errors in the observation group （42.86%） was lower than that of the control group （74.29%）（P<0.05）. Conclusion Qiprasidone and risperidone are both effective in the treatment of schizophrenia， and the former has a better effect in the near future. Ziprasidone is better in treating depression and can improve the performance of patients， with higher drug safety.

[Key words] Ziprasidone； Schizophrenia； Depression； Executive function

抑郁是精神分裂症患者的常见症状之一，据不完全统计，约20%～70%的精神分裂症患者常伴有抑郁症状[1]。此外，精神分裂症患者还常伴有执行能力障碍，生活自理困难。精神分裂症患者伴发抑郁症状后严重影响患者的预后，加重精神分裂症患者自残、自杀倾向，是引发患者自杀的独立危险因素[2]。因此积极有效的治疗精神分裂症，有利于消除和缓解抑郁症状。本研究旨在探讨齐拉西酮用于精神分裂症伴抑郁症状的疗效，现将结果报道如下。

1 资料与方法

1.1一般资料

选择2014年1月～2016年1月我院门诊和住院的伴抑郁症状的首发精神分裂症患者70例。纳入标准[3-4]：与第10版国际疾病分类（ICD-10）中关于精神分裂症的诊断标准吻合；PANSS总分≥60分；CDSS≥6分；研究前2周患者未使用抗精神病類药物；均签署知情同意书。排除标准：哺乳期或妊娠期女性及严重肝、肾、心、脑及神经系统疾病者；……