四川精神卫生2025，Vol.38Issue(2)：108-114,7.DOI:10.11886/scjsws20240802003
阿立哌唑与利培酮对慢性精神分裂症患者症状改善的效果比较
Comparision of aripiprazole and risperidone in improving psychiatric symptoms among chronic schizophrenia patients
摘要
Abstract
Background Atypical antipsychotics have been widely used in patients with chronic schizophrenia,and aripiprazole and risperidone are the most commonly used drugs.The mechanism of action of the two is different,while previous studies have provided insufficient credible evidence from multiple perspectives to support the comparative efficacy of the two drugs in improving symptoms in patients with chronic schizophrenia.Objective To compare the efficacy of aripiprazole and risperidone on the improvement of symptoms,prepulse inhibition(PPI),cognitive functioning and neurotrophic factors in patients with chronic schizophrenia,so as to provide effective treatment regimens for these patients.Methods A total of 86 patients with chronic schizophrenia attending the psychiatry department of the Third People's Hospital of Fuyang from March 2021 to March 2023 and fulfilling the diagnostic criteria of International Classification of Diseases,tenth edition(ICD-10)were enrolled and grouped using random number table method,each with 43 cases.Aripiprazole group was given oral aripiprazole once daily at an initial dose of 5 mg for one week and then gradually increased to a maximum dose of 25 mg.Risperidone group received oral risperidone twice daily at an initial dose of 0.5 mg for one week and then gradually increased to a maximum dose of 3 mg.Treatment in both groups lasted 3 months.Before treatment and 3 months after treatment,Patients were required to complete Positive and Negative Symptom Scale(PANSS),detection of both strong and weak PPIs in a startle modification passive attention paradigm,Wisconsin Card Sorting Test(WCST)and the measurement of neurotrophic factors at baseline and after treatment.The adverse reactions were recorded.Analysis of covariance was used to test the difference between the PANSS score,PPI,WCST and neurotrophic factor levels of the groups,with the pretest used as the covariate.Results 3 months after treatment,no statistical difference was found in the scores of PANSS general psychopathology subscale,positive symptom subscale,negative symptom subscale and total score between two groups after treatment(F=0.621,0.815,0.743,0.752,P>0.05).There were no statistically significant differences between the two groups in PPI inhibition rate,single intense stimulus amplitude,single intense stimulus latency,prepulse inhibition amplitude,or prepulse inhibition latency(F=0.174,0.001,0.183,0.171,0.001,P>0.05).There was no statistically significant difference in the total number of WCST tests between two groups(F=0.512,P>0.05),whereas aripiprazole group reported significantly larger total numbers of categories completed and correct responses as well as smaller total numbers of random errors and perseverative errors compared to risperidone group(F=3.737,4.621,4.892,5.130,P<0.05).A significant increase in brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)along with a reduction in glial fibrillary acidic protein(GFAP)were documented in risperidone group when compared to risperidone group(F=4.414,3.781,6.319,P<0.05).No significant difference was demonstrated in the incidence of adverse reactions between the two groups(χ2=0.261,P>0.05).Conclusion Aripiprazole may be more beneficial than risperidone in improving cognitive functioning and neurotrophic factor levels in patients with chronic schizophrenia.[Funded by Scientific Research Project of Fuyang Municipal Health Commission in 2021(number,FY2021-147)]关键词
慢性精神分裂症/阿哌利唑/利培酮/前脉冲抑制/症状改善Key words
Chronic schizophrenia/Aripiprazole/Risperidone/Prepulse inhibition/Symptom improvement分类
临床医学引用本文复制引用
王建锋,刘邦文,张艳艳,薛艳萍,郭亮,吴延海..阿立哌唑与利培酮对慢性精神分裂症患者症状改善的效果比较[J].四川精神卫生,2025,38(2):108-114,7.基金项目
2021年度阜阳市卫生健康委科研课题(项目名称:精神分裂症伴代谢障碍的认知功能研究,项目编号:FY2021-147) （项目名称:精神分裂症伴代谢障碍的认知功能研究,项目编号:FY2021-147）
