目的：探求阿立哌唑的剂量对服用利培酮的稳定期门诊精神分裂症患者认知功能的影响。方法将43例服用利培酮的稳定期门诊精神分裂症患者随机分为两组，对照组(n=22)添加(20~30)mg/d阿立哌唑，研究组(n=21)添加(5~15)mg/d阿立哌唑，治疗时间12周。分别用精神分裂症认知功能简明成套测评量表(BACS)中文版和阳性和阴性症状量表(PANSS)评估疗效，用副反应量表(TESS)评价治疗期间发生的不良反应。结果两组不良反应发生率比较，差异无统计学意义(P>0.05)，利培酮添加(5~15)mg/d阿立哌唑对患者的部分认知功能和阴性症状有明显改善，而添加(20~30)mg/d阿立哌唑，尽管和前者一样能改善运动速度(MS)和阴性症状，但对工作记忆(WM)和执行功能(EF)有显著损害(P<0.01)。结论利培酮添加低剂量而非高剂量的阿立哌唑对认知功能改善最佳。这一结果仍需大量和长期的研究加以确定。%Objective To probe the effects of dosages of aripiprazole on cognitive function of stabilized schizophrenic outpatients treated with risperidone. Methods A totol of 43 stabilized schizophrenic outpatients received risperidone were randomly divided into two groups. Aripiprazole added to control group (n=22)was taken by (20~30)mg/d and the study group(n=21)did by (5~15) mg/d,respectively, for 12 weeks. Brief Assessment of Cognition in Schizophrenia (BACS,Chinese edition)and Positive and Negative Syndrome Scale (PANSS)were used to evaluate efficacy. Treatment Emergent Symptom Scale (TESS) was used to evaluate adverse effects during this trial. Results The occurring rates of adverse effects for the two groups were not significantly different (P>0.05). Risperidone augmentation with aripiprazole by(5~15)mg/d significantly improved partial cognitive function and negative symptoms for these patients. Add-on treat-ment with aripiprazole by (20~30) mg/d significantly impair working memory(WM) and executive function (EF) (P<0.01), although that significantly improved motor speed (MS) and negative symptoms as the former did. Conclusion Risperidone augmentation with a lower rather than higher dosage of aripiprazole would improve cognitive function most favorably. These findings need further substantial and long-term trials to be established .
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