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目的：探讨阿立哌唑与利培酮对首发精神分裂症患者临床疗效和认知功能的影响。方法将68例首发精神分裂症患者随机分为两组，研究组口服阿立哌唑治疗，对照组口服利培酮治疗，观察12周。于治疗前后采用阳性与阴性症状量表评定精神症状，蒙特利尔认知评价量表评定认知功能。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（P＜0．05或0．01），研究组治疗第2周末阳性症状因子分显著高于对照组（P＜0．05），治疗第4周、8周、12周末阴性症状因子分显著低于对照组（ P＜0．05或0．01）。治疗12周末两组蒙特利尔认知评价量表总分及各因子分均较治疗前显著升高（ P＜0．05或0．01），研究组治疗第4周、8周、12周末总分及注意、延迟回忆因子分显著高于对照组（ P＜0．05或0．01）。结论阿立哌唑与利培酮均能有效控制精神分裂症患者的精神症状，改善认知功能，但利培酮对阳性症状控制起效快于阿立哌唑，阿立哌唑对阴性症状、认知功能的注意、回忆的改善优于利培酮。“,”Objective To explore influences of aripiprazole and risperidone on efficacy and cognitive func‐tions of patients with first‐episode schizophrenia .Methods Sixty‐eight first‐episode schizophrenics were randomly assigned to two groups ,research group took orally aripiprazole and control group did risperidone for 12 weeks .Mental symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) and cognitive functions with Montreal Cognitive Assessment (MoCA) before and after treatment .Results After treatment the total and each factor scores of the PANSS of both groups lowered more significantly compared with pretreatment (P<0 .05 or 0 .01) ,positive symptoms scores at the end of the 2nd week were significantly higher (P<0 .05) and negative symptoms at the end of the 4th ,8th and 12th lower (P<0 .05 or 0 .01) in research than in control group .At the end of the 12th week the total and each factor scores of the MoCA of both groups heightened more significantly compared with pretreatment (P<0 .05 or 0 .01) ,the total ,attention and delayed memory scores at the end of the 4th ,8th and 12th week were significantly higher in research than in control group (P<0 .05 or 0 .01) .Conclusion Both aripiprazole and risperidone colud effectively control schizophrenic mental symptoms and improve cognitive functions ,but risperidone takes effect more rapidly in controlling positive symptoms ,aripiprazole has an advantage over risperidone in the improvement of negative symptoms ,attention and memory .