| 摘要: |
| 目的比较棕榈酸帕利哌酮长效针剂联合认知行为干预对首发精神分裂症患者的疗效和预后的影响，及治疗后外周血脑源性神经营养因子（BDNF）水平的变化。方法将120例首发精神分裂症患者按随机数字表法分为棕榈酸帕利哌酮长效针剂联合认知行为干预组（联合治疗组）和单用棕榈酸帕利哌酮长效针剂组（单用药组），每组各60例，进行为期12个月的治疗。评定两组患者治疗前（基线）及治疗后3、6、9、12个月的阳性和阴性症状量表（PANSS）、不良反应量表（TESS）、个人和社会功能评分（PSP）量表、用药满意度问卷（MSQ），以评估疗效、安全性、社会功能和用药满意度，同时比较两组患者临床缓解率和复发率。采用酶联免疫法检测治疗前后外周血BDNF水平。结果联合治疗组临床缓解率为89.4%，高于单用药组的69.6%（P＜0.05）；复发率为1.8%，低于单用药组的7.1%（P＜0.05）；联合治疗组治疗后不同时点PANSS和PSP评分改善均优于单用药组（均P＜0.05）；两组患者治疗后BDNF水平均显著升高，但是联合组用药BDNF水平升高更多。两组患者TESS评分比较差异无统计学意义（P＞0.05），联合治疗组不同时点MSQ评分均优于单用药组（均P＜0.05）。结论棕榈酸帕利哌酮长效针剂联合认知行为干预能明显提高精神分裂症患者的临床缓解率，降低复发率，能安全有效地用于精神分裂症的维持治疗，并且显著提高患者外周血BDNF水平。 |
| 关键词: 精神分裂症 棕榈酸帕利哌酮 复发 预后 脑源性神经营养因子 |
| DOI： |
| 分类号: |
| 基金项目:温州市科技计划项目 |
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| Comprehensive cognitive intervention combined with sustainable-release paliperidone for patients with first-episode schizophrenia |
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TANG Wei, YANG Fuyin, ZHANG Jinliang, PAN Jianshe, WEN Na, CHEN Li, XIU Meihong
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Affiliated Kangning Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To evaluate the efficacy of comprehensive cognitive intervention combined with sustainable- release paliperidone in treatment of patients with first-episode schizophrenia. Methods One hundred and twenty patients with first-episode schizophrenia were randomized into two groups with 60 cases in each. Patients in study group received comprehensive cognitive intervention with sustainable-release paliperidone injection and those in control group receive paliperidone alone. Patients were treated for 12 months in both groups. The efficacy, safety, social functions and degrees of medication satisfaction in two groups were assessed with Positive and Negative Syndrome Scale (PANSS), Treatment Emergent Symptom Scale (TESS), Personal and Social Performance Scale (PSP) and Medication Satisfaction Questionnaire (MSQ) before treatment and 3, 6, 9, 12 months after treatment. The cure rate, remission rate, drug withdrawal rate, recurrence rate and
readmission rate of the two groups were compared. Results At the endpoint of the study, the long-term cure rate of study group was higher than that of control group (89.4% vs 69.6%, P＜0.05). The PANSS and PSP scores of study group were higher than those of control group (P＜0.05). MSQ showed that the satisfaction degree of study group was higher than that of oral group (P＜ 0.05). Conclusion Comprehensive cognitive intervention with sustainable-release paliperidone injection can significantly im-
prove the cure rate and reduce the recurrence rate with safety in treatment of patients with first-episode schizophrenia. |
| Key words: Schizophrenia Paliperidone Recurrence rate Treatmentefficiency BDNF |
