摘要目的:比较奥氮平与利培酮对精神分裂症患者认知功能及血清补体C3、C4、超敏C 反应蛋白的影响。方法:选取丽水市第二人民医院2018年9月至2019年9月收治的精神分裂症患者80例为研究对象，采用随机数字表法分为两组，奥氮平组（ n=40例）采用奥氮平治疗，利培酮组（ n=40例）采用利培酮治疗。观察两组治疗前后阳性和阴性症状量表（PANSS）评分及威斯康星卡片分类测试(WCST)评分；比较两组治疗前后血清多巴胺（DA）、5-羟色胺（5-TH）、去甲肾上腺素（NE）、补体C3、C4和超敏C-反应蛋白（hs-CRP）水平。 结果:治疗前，两组PANSS、WCST评分差异均无统计学意义（均 P>0.05）；治疗后，两组PANSS评分、持续错误数、随机错误数评分均较治疗前明显降低［奥氮平组：（56.23±9.37）分、（13.06±6.26）分、（16.23±6.35）分，利培酮组：（55.98±10.21）分、（13.97±6.54）分、（16.31±6.32）分］，总正确数、完成分类数评分均明显升高［奥氮平组：（29.21±2.24）分、（3.79±1.12）分，利培酮组：（29.33±2.35 ）分、（3.81±1.15）分］（ t=12.334、5.885、3.840、3.323、2.087；12.044、6.213、3.321、2.750、2.085，均 P<0.05），两组治疗后差异均无统计学意义（均 P>0.05）。治疗前，两组血清DA、5-TH、NE水平差异均无统计学意义（均 P>0.05）；治疗后，两组血清DA、5-TH、NE均明显降低［奥氮平组：（5.02±0.13）μg/L、（66.24±6.05）μg/L、（27.32±4.05）μg/L，利培酮组：（4.18±0.12）μg/L、（63.12±6.21）μg/L、（24.81±4.13）μg/L］（ t=67.800、9.977、5.082； 99.761、12.296、6.882，均 P<0.05），两组治疗后比较差异均有统计学意义（ t=30.029、2.276、6.882，均 P<0.05）。治疗前，两组血清补体C3、C4和hs-CRP水平差异均无统计学意义（均 P>0.05）；治疗后，两组血清补体C3、C4、hs-CRP水平均较治疗前显著上升［奥氮平组：（1.12±0.18）g/L、（0.24±0.06）g/L、（1.09±0.11）mg/L，利培酮组：（1.13±0.17）g/L、（0.25±0.07）g/L、（1.10±0.12）mg/L］（ t=5.129、4.049、32.452；5.147、5.164、29.227，均 P<0.05），两组治疗后比较差异均无统计学意义（ t=0.255、0.686、0.389，均 P>0.05）。 结论:奥氮平与利培酮对改善精神分裂症患者的精神症状和认知功能疗效相当，但利培酮在改善机体功能方面作用更加明显。

abstractsObjective:To investigate the effects of olanzapine versus risperidone on cognitive function, serum complement C3 and C4 levels and high sensitivity C-reactive protein (hs-CRP) level in patients with schizophrenia. Methods:Eighty patients with schizophrenia who received treatment in Lishui Second People's Hospital, China between September 2018 and September 2019 were included in this study. They were randomly assigned to receive treatment either with olanzapine (olanzapine group, n = 40) or risperidone (risperidone group, n = 40). Before and after treatment, the Positive and Negative Syndrome Scale (PANSS) score and the Wisconsin Card Sorting Test score were evaluated in each group. Before and after treatment, serum levels of dopamine, serotonin, norepinephrine, complement C3 and C4 and hs-CRP levels were compared between the olanzapine and risperidone groups. Results:Before treatment, there were no significant differences in PANSS and WCST scores between the two groups (both P > 0.05). After treatment, PANSS score, the number of perseverative errors and the number of random errors in each group were significantly decreased compared with before treatment [olanzapine group: (56.23 ± 9.37) points, (13.06 ± 6.26) points, (16.23 ± 6.35) points, t = 12.334, 5.885, 3.840, all P < 0.05; risperidone group: (55.98 ± 10.21) points, (13.97 ± 6.54) points, (16.31 ± 6.32) points, t = 12.044, 6.213, 3.321, all P < 0.05]. After treatment, the number of correct sorts and the number of categories in each group were significantly increased compared with before treatment [olanzapine group: (29.21 ± 2.24) points, (3.79 ± 1.12) points, t = 3.323, 2.087, both P < 0.05; risperidone group: (29.33 ± 2.35) points, (3.81 ± 1.15) points, t =2.750, 2.085, both P < 0.05]. After treatment, there were significant differences in these indexes between the two groups (all P > 0.05). Before treatment, there were no significant differences in serum levels of dopamine, serotonin and norepinephrine between the two groups (all P > 0.05). After treatment, serum levels of dopamine, serotonin and norepinephrine in each group were significantly decreased compared with before treatment [olanzapine group: (5.02 ± 0.13) μg/L, (66.24 ± 6.05) μg/L, (27.32 ± 4.05) μg/L, t = 67.800, 9.977, 5.082, all P < 0.05; risperidone group: (4.18 ± 0.12) μg/L, (63.12 ± 6.21) μg/L, (24.81 ± 4.13) μg/L, t = 99.761, 12.296, 6.882, all P < 0.05]. After treatment, there were significant differences in serum levels of dopamine, serotonin and norepinephrine between the two groups ( t = 30.029, 2.276, 6.882, all P < 0.05). Before treatment, there were no significant differences in complement C3 and C4 and hs-CRP levels between the two groups (all P > 0.05). After treatment, complement C3 and C4 and hs-CRP levels in each group were significantly increased compared with before treatment [olanzapine group: (1.12 ± 0.18) g/L, (0.24 ± 0.06) g/L, (1.09 ± 0.11) mg/L, t = 5.129, 4.049, 32.452, all P < 0.05; risperidone group: (1.13 ± 0.17) g/L, (0.25 ± 0.07) g/L, (1.10 ± 0.12) mg/L, t = 5.147, 5.164, 29.227, all P < 0.05]. After treatment, there were no significant differences in complement C3 and C4 and hs-CRP levels between the two groups ( t = 0.255, 0.686, 0.389, all P > 0.05). Conclusion:Olanzapine and risperidone have the same effects on improving the mental symptoms and cognitive function of patients with schizophrenia, but risperidone has more obvious effects on improving the body function than olanzapine.