神经病学与神经康复学杂志2024，Vol.20Issue(4)：115-124,10.DOI:10.12022/jnnr.2024-0255
氯氮平联合阿戈美拉汀增效治疗对慢性精神分裂症阴性症状和认知功能的疗效
The therapeutic effect of clozapine combined with agomelatine on negative symptoms and cognitive function in chronic schizophrenia
摘要
Abstract
Objective:To investigate the therapeutic effect of clozapine combined with agomelatine on negative symptoms and cognitive function in patients with chronic schizophrenia,as well as its impact on serum melatonin expression levels. Methods:98 patients with chronic schizophrenia from Shanghai Huangpu District Mental Health Center were included and randomly divided into research group and control group using a random number table,with 49 patients in each group.The control group was treated with clozapine combined with placebo,while the research group was treated with clozapine combined with agomelatine for 12 weeks.Two groups were evaluated for cognitive function,negative symptoms,and depressive symptoms at the time of enrollment and at the end of the 4th,8th,and 12th week of treatment.Serum melatonin levels were measured by mass spectrometry analysis at the same time point.Statistical analysis was performed on the relevant indicators of the two groups. Results:Excluding dropouts,the study group and control group ultimately included 42 patients each.During the baseline period,there was no statistically significant difference in cognitive function dimensions,negative symptoms,depressive symptoms,and serum melatonin levels between the two groups.After 12 weeks of treatment,there were statistically significant differences in N3(emotional communication disorder)(P=0.027),vocabulary recall(P=0.016),story recall(P=0.002),graphic recognition(P=0.017),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)conversion score(P=0.007),Calgary Depression Scale for Schizophrenia(CDSS)(P=0.000)score,and serum melatonin levels(P=0.002)between the two groups.Within the group comparison,there were statistically significant differences in cognitive function,negative symptom and depression symptom scores,and serum melatonin levels between the treatment group at the 4th,8th,and 12th weekends and the baseline period(P＜0.01 for all).There was a significant correlation between changes in serum melatonin levels and improvements in story recall(r2=0.25,P=0.02). Conclusion:Clozapine combined with agomelatine has significant therapeutic effects on some dimensions of cognitive function,negative symptoms,and depressive symptoms in patients with chronic schizophrenia,and the improvement of some cognitive functions is significantly correlated with changes in serum melatonin levels.关键词
精神分裂症/阴性症状/认知功能/褪黑素/阿戈美拉汀Key words
Schizophrenia/Negative symptoms/Cognitive function/Melatonin/Agomelatine引用本文复制引用
胡国芹,谢艳艳,杨俊杰,孙秀佳,沈莉莉..氯氮平联合阿戈美拉汀增效治疗对慢性精神分裂症阴性症状和认知功能的疗效[J].神经病学与神经康复学杂志,2024,20(4):115-124,10.基金项目
上海市卫生健康委员会科研课题(20194Y0406) （20194Y0406）
上海市黄浦区科学技术委员会科研计划项目(HKQ201813) （HKQ201813）
上海市黄浦区卫生计生系统专业人才梯队培养计划(2019GG11) （2019GG11）
上海交通大学医工交叉研究基金(YG2021QN131)Scientific Research Project of Shanghai Municipal Health Committee(20194Y0406) （YG2021QN131）
Shanghai Huangpu District Science and Technology Commission Scientific Research Project(HKQ201813) （HKQ201813）
Shanghai Huangpu District Health and Family Planning Professional Talent Echelon Training Plan(2019GG11) （2019GG11）
Shanghai Jiao Tong University Medical-Industrial Interdisciplinary Fund(YG2021QN131) （YG2021QN131）
