杨辉

[摘要] 目的 研究喹硫平或丙戊酸鎂联合碳酸锂对双相情感障碍（BD）躁狂发作患者阳性与阴性症状量表（PANSS）、倍克-拉范森躁狂量表（BRMS）评分的影响。 方法 选取2018年4月至2020年7月于我院诊疗的BD躁狂发作患者118例作为本研究对象，采用简单随机分组方法分为A组39例、B组38例和C组41例，均给予碳酸锂治疗，B组和C组在此基础上分别联合喹硫平和丙戊酸镁治疗，比较三组患者治疗前、治疗1个月后PANSS、BRMS评分和认知功能相关指标变化，并记录两组患者不良反应发生情况。 结果 治疗前，三组患者PANSS、BRMS评分、言语记忆评分和CPT评分比较，差异无统计学意义（P>0.05），治疗1个月后三组患者PANSS、BRMS评分均降低，B组和C组患者PANSS、BRMS评分降低幅度高于A组，差异有统计学意义（P<0.05），B组患者言语记忆评分和CPT评分升高幅度>C组>A组，差异有统计学意义（P<0.05）;三组患者不良反应总发生率比较，差异无统计学意义（P>0.05）。 结论 喹硫平联合碳酸锂或丙戊酸镁联合碳酸锂治疗BD躁狂发作患者均可显著改善患者极端情绪程度，且安全性高，但喹硫平联合碳酸锂在改善患者言语记忆和持续操作方面效果优于丙戊酸镁联合碳酸锂治疗。

[关键词] 喹硫平;丙戊酸镁;碳酸锂;双相情感障碍;躁狂发作;认知功能

[中图分类号] R749.4          [文献标识码] A   ;       [文章编号] 1673-9701（2021）30-0010-03

[Abstract] Objective To study the effect of quetiapine or magnesium valproate combined with lithium carbonate on the Positive and Negative Symptom Scale （PANSS） and Bech-Rafaelsen Mania Rating Scale （BRMS） for patients with bipolar disorder（BD） manic episodes. Methods A total of 118 patients with BD manic episode who were diagnosed and treated in our hospital from April 2018 to July 2020 were selected as subjects in this study. They were divided into group A （39 cases）， group B （38 cases） and group C （41 cases）， and treated with lithium carbonate. Group B and Group C were also treated with quetiapine and magnesium valproate， respectively. The PANSS and BRMS scores and the changes in related indicators of cognitive function of the three groups were compared before treatment and after one month of treatment. The occurrence of adverse reactions of the two groups were recorded. Results Before treatment， there were no statistically significant differences in PANSS， BRMS scores， verbal memory scores and CPT scores among the three groups of patients （P>0.05）. After one month of treatment， the PANSS and BRMS scores of the three groups were all reduced. The decrease in PANSS and BRMS scores of group B and group C was higher than that of group A，the difference was statistically significant（P<0.05）. The increase in verbal memory score and CPT score of group B was higher than group C and group A， the difference was statistically significant（P<0.05）. The difference in the total incidence of adverse reactions between the three groups of patients was not statistically significant after statistical analysis （P>0.05）. Conclusion Quetiapine combined with lithium carbonate or magnesium valproate combined with lithium carbonate can significantly improve the extreme mood of patients with BD with high safety. However， quetiapine combined with lithium carbonate is better than magnesium valproate combined with lithium carbonate in improving patients' verbal memory and continuous operation.

[Key words] Quetiapine; Magnesium valproate; Lithium carbonate; Bipolar disorder; Manic attack; Cognitive function

双相情感障碍（Bipolar disorder，BD）属于心境障碍疾病，根据患者临床发作特点分为抑郁发作、躁狂发作和混合发作，有研究表明[1-2]，躁狂发作患者言语记忆和持续操作能力显著下降，给予碳酸锂治疗虽可在一定程度上缓解患者病情，但其不良反应较多，见效速度较慢，使躁狂发作患者后续治疗依从性降低。……