中文摘要：

背景精神分裂症患者听觉感觉门控（以下简称感觉门控）P50受损,各种抗精神病药物对该P50的作用仍有争议。假设第二代抗精神病药物氯氮平治疗的精神分裂症患者比氯丙嗪治疗患者的感觉门控P50的改善明显。方法前瞻性对照研究纳入刚住院的精神分裂症患者,由治疗医师决定氯氮平治疗者26例（研究组）,氯丙嗪治疗者30例（对照组）。氯氮平组有23例完成8周研究纳入分析,氯丙嗪组为20例。检测P50的方法为双短声刺激[听觉条件（S1）-测试刺激（S2）范式],检测时点为基线、治疗第4周和第8周。临床症状用阳性与阴性综合征量表（Positive and Negative Syndrome Scale,PANSS）评定。结果两组年龄、性别、教育程度、病程和基线PANSS总分差异均无统计学意义。氯丙嗪组平均（标准差）治疗剂量为389（96）mg/d,氯氮平组为345（117）mg/d。重复测量的方差分析显示,氯氮平组颅顶中央脑区（central zone,Cz）P50比值（S2/S1）的下降比氯丙嗪组明显[基线为108%比106%,第4周94%比102%,第8周84%比95%,F=4.91,P=0.029],而S1和S2波幅差异无统计学意义。两组间S1和S2的波幅无明显差异。氯氮平组治疗后P50比值较治疗前下降（F=4.39,P=0.014）,氯丙嗪组治疗前后P50比值没有明显变化。结论氯氮平治疗可以减轻精神分裂症患者感觉门控的受损程度;与氯丙嗪治疗相比,氯氮平治疗者的改善程度较明显。

英文摘要：

Background：Patients with schizophrenia have deficits in their P50 auditory sensory gating but the effect of different antipsychotic medications on patients’ P50 sensory gating remains controversial.Hypothesis：The improvement in P50 auditory sensory gating of patients with schizophrenia is greater when they are treated with the second generation antipsychotic clozapine than when treated with the first generation antipsychotic chlorpromazine.Methods：This prospective case-control study of inpatients with schizophrenia enrolled at the time of admission included 26 patients treated by their attending physician with clozapine（cases）and 30 patients treated with chlorpromazine（controls）.23 patients in the clozapine group and 20 patients in the chlorpromazine group completed the 8-week trial and were included in the analysis.The P50 was measured using auditory double click stimuli [the conditioning stimuli（S1）-testing stimuli（S2）paradigm];this assessment was conducted at baseline and at 4 weeks and 8 weeks after initiation of treatment.Clinical symptoms were assessed with the Positive and Negative Syndrome Scale（PANSS）.Results：There were no statistically significant differences between the groups in age,gender,educational level,duration of illness,or baseline PANSS total score;the mean（SD）daily therapeutic dose of chlorpromazine and clozapine were 389（96）mg and 345（117）mg,respectively.Repeated measures analysis of variance showed that the mean P50 ratio（S2/S1）at the vertex（central zone,Cz）decreased more rapidly in the clozapine group than in the chlorpromazine group（108% vs.106% at baseline,94% vs.102% at 4 weeks,and 84% vs.95% at 8 weeks;F=4.91,P=0.029）.The amplitude of S1 and S2 did not differ significantly between the two groups.The pre-versus post-treatment P50 ratio decreased significantly in the clozapine group（F=4.39,P=0.014）but not in the chlorpromazine group.Conclusion：Clozapine treatment can significantly reduce the auditory sensary gating dysfunction e