齐拉西酮与阿立哌唑对首次治疗的精神分裂症患者急性期疗效及代谢的影响

目的 探讨齐拉西酮和阿立哌唑对首次治疗的精神分裂症患者急性期疗效及代谢的影响. 方法 将自2010年2月至2011年2月中山大学附属第三医院精神科收治的46例未经治疗的精神分裂症患者按随机数字表法分为齐拉西酮组和阿立哌唑组,分别给予齐拉西酮平均(165±13.51) mg/d]和阿立哌唑平均(28.86±3.06) mg/d]治疗,自然观察6周.在基线和观察终点分别评定两组患者阳性症状与阴性症状量表(PANSS)及检测体重指数(BMI)、空腹血糖(FBG)、胰岛素(INS)、C肽(CP)、胰岛素抵抗指数(IR)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、载脂蛋白a(APOA)、载脂蛋白b(APOB). 结果 观察终点时,阿立哌唑组的痊愈率、显著进步率、好转率、无效率分别为9.1％(2/22)、31.8％(7/22)、40.9％(9/22)、18.2％(4/22),齐拉西酮组分别为0％(0/24)、29.2％(7/24)、50％(12/24)、20.8％(5/24).经过6周治疗后,两组患者PANSS量表评分均较基线时明显下降,差异均有统计学意义(P＜0.05)；齐拉西酮组BMI(20.14±2.63) kg/m2]较基线时(19.68±2.76) kg/m2]升高,差异有统计学意义(P＜0.05)；阿立哌唑组FBG(4.38±0.59) mmmol/L]较基线时(4.79±0.59) mmol/L]下降,BMI (19.65±2.15) kg/m2]较基线时(19.19±2.28) kg/m2升高,差异均有统计学意义(P＜0.05)；其他各项代谢指标较基线时差异无统计学意义(P＞0.05). 结论 齐拉西酮和阿立哌唑对精神分裂症患者急性期均具有较好疗效,均有轻微体质量增加作用,对糖脂代谢无明显影响.

Curative effects of ziprasidone and aripiprazole at acute stage on patients with drug-naive schizophrenia and their effects on metabolism of these patients

Objective To compare the curative effects ofziprasidone and aripiprazole at acute stage on patients with drug-naive schizophrenia and their effects on metabolism of these patients.Methods Forty-six patients with drug-naive schizophrenia,admitted to our hospital from February 2010 to February 2011,were divided into ziprasidone treatment group (n=24,165±13.51] mg/d) and aripiprazole treatment group (n=22,28.86±3.06] mg/d); these patients were given the above treatment for 6 week.The scores of positive and negative syndrome scale (PANSS),body mass index (BMI),insulin resistance index (IRI),and levels of fasting blood glucose (FBG),insulin (INS),C-Peptide (CP),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),apolipoprotein-a (APOA) and apolipoprotein-b (APOB) were obtained before and at the end of treatment.Results At the end of treatment,2 patients (9.1％) were cured,7 (31.8％)achieved obvious improvement,9 (40.9％) achieved improvement,and only 4 (18.2％) did not achieve any improvement in the aripiprazole treatment group.However,at the end of treatment,no patient (0％)was cured,7 (29.2％) achieved obvious improvement,12 (50％) achieved improvement,and 5 (20.8％)did not achieve any improvement in the ziprasidone treatment group.The total scores of PANSS after the treatment in both groups decreased significantly as compared with those before treatment (P＜0.05).The BMI (20.14±2.63] kg/m2) in the ziprasidone treatment group at the end of treatment was obviously increased as compared with that (19.68±2.76] kg/m2) before treatment (P＜0.05).The FBG (4.38±0.59]mmmol/L) at the end of treatment decreased significantly as compared with those before treatment (4.79±0.59] mmmol/L),and the BMI (19.65±2.15] kg/m2) was obviously increased as compared with that before treatment (19.19±2.28] kg/m2) in the aripiprazole treatment group (P＜0.05).The metabolic index in the 2 groups was not significantly different at the end of the treatment (P＞0.05).Conclusion Both ziprasidone and olanzapine are effective in the treatment of patients with drug-naive schizophrenia;both of them have mild effects on weight of patients with drug-naive schizophrenia,but no obvious effects on other metabolic indices.