齐拉西酮治疗老年期首发精神分裂症的疗效及对糖、脂代谢的影响

背景:随着我国人口老龄化的出现,老年期首发精神分裂症有逐渐增多趋势,合理选择治疗药物成为一个值得关注的问题.目的:探讨齐拉西酮治疗老年期首发精神分裂症的临床疗效及其对糖、脂代谢指标的影响.方法:采用区组随机化分组,将38例老年期首发精神分裂症患者随机分为齐拉西酮治疗组(研究组)与奥氮平治疗组(对照组)各19例.分别于治疗前、4周末、8周末、12周末采用阳性与阴性症状量表(PANSS)评定疗效,副反应量表(TESS)评定药物不良反应.同时测量空腹血糖(FBG)及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-c).结果:两组PANSS评分4周、8周、12周末均无显著差异,两组疗效相当.重复测量方差分析显示治疗期间研究组与对照组的空腹血糖(FBG)(Ftime×group=7.539,p=0.001)及总胆固醇(TC)(Ftime×group=32.194,p<0.001)、甘油三酯(TG)(Ftime×group=488.312,p<0.001)、低密度脂蛋白(LDL-c)(Ftime×group=9.380,p<0.001)均有显著性差异.结论:齐拉西酮治疗老年期精神分裂症疗效确切,对糖、脂代谢影响较小,适合老年患者长期服用.

Efficacy and metabolic influence on blood-glucose and serum lipid of ziprasidone in the treatment of elderly patients with first-episode schizophrenia

Background: As the age of the population in China rises, the occurrence of first-episode of schizophrenia in elderly persons is also gradually increasing. However, studies examining selection of therapeutic drugs for this population are relatively few. Objective: To examine the therapeutic efficacy and metabolic influence on blood-glucose and serum lipid of ziprasidone in the treatment of elderly patients with first-episode schizophrenia. Methods: Using randomized grouping, 38 elderly patients with first-episode schizophrenia were randomly divided into the ziprasidone treatment group (i.e. the study group) and the olanzapine treatment group (i.e. the control group), with 19 cases in either group respectively. The positive and negative symptoms scale (PANSS) was used to evaluate the efficacy, and adverse drug reaction scale (TESS) was used to evaluate adverse drug reactions, at the points prior to the treatment, at the end of 4th, 8th, and 12th weeks of treatment, respectively. Fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), and low density lipoprotein (LDL-c) were also measured. Results: There was no significant difference between the two groups in PANSS score at the end of week 4, week 8 and week 12. The curative effect on the two groups was similar. The results of repeated measure ANOVA showed that there were significant differences in FBG( Ftime×group=7.539, p=0.001), TC(Ftime×group=32.194, p<0.001), TG(Ftime×group=488.312, p<0.001), and LDL-c (Ftime×group=9.380, p<0.001)between the study group and the control group across the different time points. Conclusion: Ziprasidone in the treatment of first episode schizophrenia in elderly patients has efficacy and less effect on blood-glucose and serum lipid metabolism.