Effects Of Hemorheology Indexes On Cognitive Function Of Patients With Schizophrenia And The Mechanism Of Drug Intervention

Objective:Effects of hemorheology indexes on cognitive function of patients with schizophrenia and the mechanism of drug intervention.Methods:(1)Collect 80 first-episode schizophrenia(FES)patients who meet the inclusion exclusion criteria as the case group,recruit 76 healthy volunteers matching the age and gender of the case group as the healthy control group,and collect The general demographic data of all subjects were tested for their hemorheology indicators,and the repeated set of Neuropsychological Status Test(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)was used to assess the cognitive function of all subjects.The group used Positive and Negative Syndrome Scale(PANSS)to evaluate the severity of the disease.The independent sample t test or chi-square test was used to compare the general data and hemorheology indexes of the two groups;pearson correlation analysis was used to analyze the correlation between the hemorheology index levels of the case group and the severity of disease and cognitive function.(2)72 patients with abnormal blood rheology indexes in the above case group were selected as the second part of the research object,and were randomly divided into 2groups,36 in each group,and the experimental group was given oral low-dose risperidone tablets(2-3mg / d)combined with low-dose sertraline tablets(50mg / d),the control group was given oral high-dose risperidone tablets(4-6mg / d).After 12 weeks of treatment,PANSS,RBANS and A Rating Scale for Extrapyramidal Side Effects(RESES)were evaluated,blood rheology index levels and serum prolactin(PRL)levels were measured,and phenhexol statistics Tablet usage.Chi-square test was used to analyze the PANSS reduction rate of the experimental group and the control group,and the independent sample t test was used to compare the above indexes before and after treatment in the two groups.Results:First part(1)Compared with the control group,the general demographic data of the case group is not statistically significant(P> 0.05).Except for plasma viscosity,erythrocyte sedimentation equation K value and red blood cell deformation index,male patients in the case group have the other blood rheology The biological indexes were significantly higher than those of the control group(P <0.01);female patients in the case group except plasma viscosity,hematocrit,erythrocyte sedimentation rate and erythrocyte sedimentation equation K value,the rest of the hemorheological indexes were significantly higher than the control group females(P <0.01).(2)Pearson correlation analysis showed that the positive symptoms in the case group were positively correlated with whole blood low-cut viscosity 1:00,whole blood viscosity low-cut 5:00,hematocrit,and relative index of whole blood low-cut;negative symptoms were correlated with total Blood low-cut reduced viscosity,red blood cell aggregation index and red blood cell electrophoresis index were positively correlated;PANSS total score was positively correlated with whole blood high-cut reduced viscosity;RBANS total score was low with whole blood viscosity cut 1:00,whole blood reduced viscosity low cut 5: 00.Whole blood viscosity mid-cut 30:00,whole blood viscosity high-cut 200: 00 and carson viscosity are negatively correlated;immediate memory and whole blood viscosity low-cut 1:00,whole blood viscosity low-cut 5:00 and erythrocyte pressure Volume is negatively correlated;language function is negatively correlated with whole blood viscosity low cut 5:00,whole blood viscosity mid cut 30:00 and carson viscosity;note that it is negatively correlated with plasma viscosity;delayed memory is negatively correlated with red blood cell aggregation index.(3)After multi-factor correction of age,gender and BMI,the multiple regression model showed that low blood viscosity 1: 100 was positively correlated with the positive symptoms of the case group(P = 0.049),and negatively with the total cognitive score Correlation(P = 0.036);red blood cell aggregation index was positively correlated with negative symptoms(P = 0.039),and negatively correlated with delayed memory(P =0.045);whole blood viscosity was low in language and hemorheology indicators 5: 00(P= 0.043)was negatively correlated with the whole blood viscosity mid-cut 30:00(P =0.033).Second part(1)Shedding during the 12-week follow-up period: 1 case in the experimental group was lost due to loss of follow-up,3 cases in the control group were lost due to severe drug side effects(1 case had amenorrhea due to serum prolactin levels greater than 5000 m IU / L,and 1 case swallowed Difficulty and 1 case of seizure).The experimental group had no shedding due to serious drug side effects,and the shedding rate was significantly lower than that of the control group.(2)There was no significant difference in general demographic data between the two groups before treatment.After 12 weeks of treatment,the total clinical efficacy rate of the experimental group was significantly higher than that of the control group(977.2%vs 77.8%).The negative symptoms and cognitive functions of the experimental group(especially In terms of attention function,language function and visual breadth,etc.)and the improvement of hemorheology indicators were significantly better than the control group(P <0.05).There was no difference in the improvement of positive symptoms between the two groups(P> 0.05).The experimental group's RESES score,serum prolactin level and the dosage of diphenhydroxide tablets were significantly lower than those of the control group.Conclusion:(1)The blood rheology index level of FES is significantly higher than that of healthy subjects.(2)The higher the whole blood viscosity level in the blood rheology index,the more serious the positive symptoms of FES and the overall cognitive impairment;the higher the red blood cell aggregation index,the more serious the negative symptoms and delayed memory impairment;the low blood whole blood viscosity The higher the cut at5:00 and the cut at 30:00 in the whole blood viscosity,the more severe the impairment of language function.(3)Low-dose risperidone tablets combined with low-dose sertraline tablets significantly improved the cognitive function and negative symptoms of FES with hemorrheological abnormalities,and was significantly better than those treated with medium-high-dose risperidone tablets alone,The side effects of the drug are smaller.There was no difference in the improvement of positive symptoms between the two groups,indicating that reducing the dose of risperidone tablets did not reduce the elimination of their positive symptoms.