利培酮和阿立哌唑治疗学龄前儿童DBD和ADHD的临床研究

目的 比较利培酮和阿立哌唑在治疗患有注意缺陷多动障碍(ADHD)合并破坏性行为障碍(DBD)的学龄前儿童用药的有效性和安全性.方法 将36名3~6岁ADHD合并DBD的儿童随机分为两组,每组18人,分别给予利培酮和阿立哌唑进行为期8周的临床治疗,治疗开始和治疗后第2、第4、第8周末根据临床总体印象(CGI)和Conners量表的检测标准进行评分.结果 两组治疗各阶段的Conners评分比较差异均无统计学意义(P>0.05).与治疗前相比,治疗后第2周两组多动评分(利培酮组:t=2.988,P<0.05;阿立哌唑组:t=2.682,P<0.05)、注意力不集中(利培酮组:t=2.988,P<0.05;阿立哌唑组:t=2.130,P<0.05)、ADHD(利培酮组:t=2.881,P<0.05;阿立哌唑组:t=3.756,P<0.05)、ODD(利培酮组:t=2.988,P<0.05;阿立哌唑组:t=2.247,P<0.05)及耐受性(利培酮组:t=6.255,P<0.05;阿立哌唑组:t=5.889,P<0.05)均明显降低,差异均有统计学意义.治疗后第4周和第8周的测量指标与第2周比较差异均无统计学意义(均P>0.05).与治疗前比较,治疗终点两组的体重和空腹血糖(FBS)增加水平差异均无统计学意义(P>0.05).治疗终点利培酮组血清泌乳素水平增加量较阿立哌唑组高,差异有统计学意义(t=34.087,P<0.05).结论 利培酮和阿立哌唑在减轻ADHD合并DBD症状方面的临床疗效相似,安全性相当;但两种药物出现副作用的概率均较高,临床用药需谨慎.

Clinical study of risperidone and aripiprazole in treatment of preschool children with disruptive behavior disorder and attention deficit hyperactivity disorder

Objective To compare the efficiency and safety of risperidone and aripiprazole in treatment of preschool children with attention deficit hyperactivity disorder (ADHD) combined with disruptive behavior disorder (DBD).Methods Thirty-six 3 -6 year-old children diagnosed with ADHD combined with DBD were randomly divided to two groups with 18 cases in each .An 8-week treatment with risperidone or aripiprazole was given to different groups .Assessment was performed by Conners ' rating scale-revised and clinical global impression scale (CGI) before treatment and at end of week 2, 4, and 8 of treatment.Results Conners rating score did not have statistical differences between two groups in any stage of evaluation (P>0.05).After 2-week of treatment, scores of hyperactivity (risperidone group t=2.988, P <0.05; aripiprazole group t =2.682, P <0.05), impaired concentration (risperidone group t =2.988, P <0.05;aripiprazole group t=2.130, P<0.05), ADHD (risperidone group t=2.881, P<0.05; aripiprazole group t=3.756, P<0.05), oppositional defiant disorder (ODD) (risperidone group t=2.988, P<0.05; aripiprazole group t =2.247, P<0.05) and tolerance (risperidone group t=6.255, P<0.05;aripiprazole group t=5.889, P<0.05) in two groups decreased significantly compared to those of pre-treatment, and all differences had statistical significance .Indexes measured at fourth and eighth week of treatment in two groups had no statistically significant difference compared to those at second week of treatment (all P>0.05).Mean increase in weight and fasting blood sugar (FBS) in two groups at end point of treatment were both not significantly different from that before treatment (P>0.05). Increase of mean serum prolactin in risperidone group at end of treatment was higher than that in aripiprazole group , and the difference was statistically significant ( t =34.087, P <0.05).Conclusion Risperidone is similar to aripiprazole in reducing symptoms of ADHD combined with DBD with equal safety , but both drugs show high incidence of side effect .Clinical medication should be cautious .