可变剂量阿立哌唑、喹硫平与利培酮治疗青少年首发精神分裂症近期疗效与安全性比较

目的:评价阿立哌唑、喹硫平和利培酮治疗青少年首发精神分裂症的近期疗效及安全性。方法:采用病例对照研究设计,95例精神分裂症患者随机分为阿立哌唑组、喹硫平组和利培酮组,疗程8周。基线和8周末,以阳性和阴性症状量表(PANSS)总分和分量表分变化及有效率为疗效指标,副反应量表(UKU)及锥体外系副反应量表(RSESE)进行安全性评价,同时基线、4周末、8周末测定代谢指标。结果:治疗第8周末,3组药物PANSS总分减分率无显著性差异,利培酮组、阿立哌唑组、喹硫平组PANSS总分分别从治疗前的(89.75±8.50,89.65±9.98,88.63±9.87)减至(53.00±13.37,54.32±16.86,56.81±13.71),3组减分率差异无统计学意义,利培酮组、阿立哌唑组、喹硫平组有效率分别为71.88%,70.97%,68.75%;3组有效率的差异无统计学意义(H=1.284,P=0.526)。不良反应(UKU、RSESE)评估中,3组药物不良反应均为轻、中度,喹硫平组头昏和昏厥发生例数明显多于利培酮组和阿立哌唑组;而利培酮组和阿立哌唑组步态、腿的摆动发生例数明显多于喹硫平组。结论:阿立哌唑、喹硫平和利培酮治疗青少年首发精神分裂症均有效,且3种药物的近期疗效相当,有效率无显著性差异。3组药物不良反应均可耐受,阿立哌唑和利培酮近期不良反应相似,以锥体外系反应为主;而喹硫平组以头昏为主。

Comparison of Efficacy and Safety of Three Kinds of Atypical Antipsychotics in Adolescent Patients with First -episode Schizophrenia

Objective:To investigate the clinical efficacy and safety of aripiprazole ,quetiapine and risperidone in treatment of the adolescent patients with first -episode schizophrenia .Methods :In the 8-week randomly controlled trial ,95 patients with schizophrenia were randomly assigned into aripiprazole group ,quetiapine group and risperidone group to receive mono -therapy for 8 weeks .The positive and negative syndrome scale (PANSS ) ,the Udvalg for Kliniske Unders Lgelser Side Effect Rating Scale (UKU ) ,rating scale for extrapyramdal side effects (RSESE)were assessed at baseline and 8 weeks .Metabolic measures were determined at baseline and again at weeks 4 and 8 .Re-sults:At the end of 8 weeks ,PANSS -total scores in risperidone group ,aripiprazole group and quetiapine group de-creased from the baseline of (89 .75 ± 8 .50 ,89 6.5 ± 9 .98 ,88 .63 ± 9 .87) to (53 .00 ± 13 .37 ,54 .32 ± 16 .86 ,56 .81 ± 13 7.1) ,respectively ,and there were no statistically significant difference among thcthe groups (F(2 9.3)=1 0.28 ,P=0 3.62) ,and the effective rate were 71 8.8% ,70 9.7% and 68 7.5% respectively .There were no significant differences among the three groups(H=1 2.84 ,P=0 5.26) .Of the drug adverse reactions ,patients in quetiapine group felt dizzi-ness significantly more than the number of cases in risperidone group and aripiprazole group ,while there were signif-icant increase of patients'gait and the legs swinging in risperidone group and aripiprazole group than in quetiapine group .Conclusion:Aripiprazole ,quetiapine and risperidone are all effective in the treatment of the adolescent patients with first -episode schizophrenia ,Their curative effect are similarity .They all have little untoward reaction .Aripi-prazole and risperidone have similar untoward reaction short -termly in extrapyramidal symptom ,and ouetiapine have untoward reaction mainly in dizziness .