可变剂量帕利哌酮缓释片治疗急性期精神分裂症的疗效及对糖脂代谢的影响

目的:研究可变剂量帕利哌酮缓释片治疗急性期精神分裂症的有效性、耐受性及其对糖脂代谢的影响。方法:采用开放、单组研究,使用可变剂量(3～12 mg)帕利哌酮缓释片治疗急性期精神分裂症患者,为期8周。使用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评价有效性,治疗后较基线减分率≥30%为有效,同时比较治疗后PANSS总分及各分量表得分较基线的差异。测量血压、腹围、空腹血糖(fsat plasma glucose,FPG)、总胆固醇(total cholesterol,TG)及三酰甘油(triglyceride,TC),比较治疗后与基线的差异。结果:符合入组标准患者55例,最终纳入有效统计为48例。治疗8周末的有效率为79.17%,PANSS总分与基线相比有统计学意义(P<0.01)。治疗终点时45.83%患者的剂量为9 mg.d-1,43.75%为6 mg.d-1,2.08%的患者因不能耐受而下调剂量至3 mg.d-1。患者腹围在治疗8周末较基线增加(P<0.01)。血糖、血压及总胆固醇无明显变化。结论:可变剂量帕利哌酮缓释片治疗急性期分裂症有效,耐受性好,对糖脂代谢影响有待进一步研究。

Efficacy of extended release paliperidone at flexible-dose and its influence on glucose and lipid metabolism in patients with acute schizophrenia

Objective: To evaluate the efficacy of extended release paliperidone at flexible-dose and its influence on glucose and lipid metabolism in patients with acute schizophrenia.Methods: In an open-labled and one-aim trial,patients with acute schizophrenia were treated with doses of extended release paliperidone(3～12 mg) for 8 weeks.Positive and negative scale(PANSS) was used to evaluate efficacy.The efficacy was defined as a reduction rate of more than 30%.The changes in total score of PANSS and sub-scales after treatment were analyzed.Blood pressure,abdominal circumference,fast plasma glucose(FPG),total cholesterol(TG) and triglyceride(TC) were measured.Results: Fifty-five patients met the criteria were enrolled and data of 48 patients were statistically analyzed.The response rate at the 8th week was 79.17%.The total score of PANSS was significantly lower than that of base line(P<0.01).The dose of paliperidone at the endpoint of treatment remained 9 mg·d-1 in 45.83% patients and 6 mg·d-1 in 43.75% patients,and reduced to 3 mg·d-1 in 2.08% patients because of intolerance.The abdominal circumference increased(P<0.01) at 8 weeks after treatment.There was no statistically significant difference in fast glucose,blood pressure and total cholesterol.Conclusion: Flexible dose treatment with extended release paliperidone is effective and tolerated.The influence of paliperidone on glucose and liqid metabolism should be further studied.