利培酮联合小剂量阿立哌唑对伴有攻击行为的精神分裂症患者认知功能的影响

The effect of risperidone combined with low-dose aripiprazole on cognitive function in patients with schizophrenia accompanied by aggressive behavior

摘要:

目的 探讨利培酮联合小剂量阿立哌唑对伴有攻击行为的精神分裂症患者认知功能的影响。方法 选取2020年8月—2024年8月联勤保障部队第987医院收治的精神分裂症患者108例，按随机数字表法分为A、B两组，各54例。A组采用利培酮+小剂量阿立哌唑治疗，B组采用利培酮治疗。采用阴性和阳性症状量表（PANSS）评估两组患者精神症状，比较两组血清神经递质［多巴胺（DA）、去甲肾上腺素（NE）、5-羟吲哚乙酸（5-HIAA）］水平，采用外显攻击行为量表（MOAS）评估攻击行为，采用中修版韦氏成人智力量表（WAIS-RC）评估认知功能，比较两组的不良反应。结果 A组治疗前后阳性症状、阴性症状、一般病理症状评分的差值均大于B组（P <0.05）。A组治疗前后DA、NE、5-HIAA的差值均大于B组（P <0.05）。A组治疗前后言语、自身、体力、财产等攻击行为评分的差值均大于B组（P <0.05）。A组治疗前后言语、操作评分的差值均大于B组（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 利培酮联合小剂量阿立哌唑可有效改善患者精神症状，缓解其暴力攻击行为，提高认知功能，并具有较高的安全性。

Abstract:

Objective To explore the effects of risperidone combined with low-dose aripiprazole on cognitive function in patients with schizophrenia and aggressive behavior.Methods Totally 108 patients with schizophrenia admitted to the 987th Hospital of the Joint Logistics Support Force from August 2020 to August 2024 were selected and randomly divided into two groups, A and B, with 54 cases in each group, using a random number table method. Group A patients were treated with risperidone and low-dose aripiprazole, while Group B patients were treated with risperidone. A comparison was made of the mental symptoms [evaluated using negative and positive symptom scales (PANSS) ], serum neurotransmitters [dopamine (DA), norepinephrine (NE), 5-hydroxyindoleacetic acid (5-HIAA) ], aggressive behavior [assessed using the Modified Overt Aggression Scale (MOAS) ], cognitive function [assessed using the revised version of the Wechsler Adult Intelligence Scale (WAIS-RC) ], and adverse reactions.Results The difference in scores of positive symptoms, negative symptoms, and general pathological symptoms before and after treatment in Group A was greater than that in Group B (P < 0.05). The differences in DA, NE, and 5-HIAA before and after treatment in Group A were greater than those in Group B (P < 0.05). The difference in scores of aggressive behaviors such as speech, self, physical strength, and property before and after treatment in Group A was greater than that in Group B (P < 0.05). The difference in speech and operation scores before and after treatment in Group A was greater than that in Group B (P < 0.05). There was no statistically significant difference in the total incidence of adverse reactions between Group A and Group B (P > 0.05).Conclusion Risperidone combined with low-dose aripiprazole can effectively improve patients' mental symptoms, alleviate their violent and aggressive behavior, enhance cognitive function, and have high safety.