两种不同剂型的帕利哌酮对精神分裂症远期疗效和预后的影响

目的：比较两种不同剂型的帕利哌酮（棕榈酸帕利哌酮注射液和口服帕利哌酮缓释片片剂）对精神分裂症远期痊愈率、缓解率、复发率和再住院率的影响.方法：60例口服帕利哌酮缓释片3～12mg/d达6周且病情稳定的精神分裂症患者,被随机分为棕榈酸帕利哌酮注射液组（长效针剂组）和口服帕利哌酮缓释片组（口服组）进行为期12个月的治疗.独立且经严格培训的量表评定人员评估两组分组前（0月基线）及分组后3、6、9、12月的阳性和阴性症状量表（PANSS）、不良反应量表（TESS）、个人和社会功能评分（PSP）量表、用药满意度问卷（MSQ）以评定疗效、安全性、社会功能和用药满意度,同时比较两组的痊愈率、缓解率、停药率、复发率和再住院率.结果：至研究终点,长效针剂组的临床治愈率为33.7%、缓解率为61.0%,均高于口服组14.3%和54.8%（P＜0.05）;PANSS和PSP评分长效针剂组改善均优于口服组（P＜0.05）;两种治疗方法对患者都是安全和可耐受的 （P＞0.05）;MSQ问卷显示长效针剂组满意度明显优于口服组（P＜0.05）.长效针剂组l例发生停药、1例复发、无再住院病例,口服组8例不同程度停药、5例复发和1例再住院（P＜0.05）.结论：棕榈酸帕利哌酮注射液能明显提高精神分裂症患者痊愈率和缓解率,降低治疗停药率、复发率和再住院率,能安全有效地用于精神分裂症的维持治疗.

Influences of two different paliperidone formulations on long-term effects and prognosis for patients with schizophrenia

ObjectiveTo compare influences of two different paliperidone formulations （paliperidone palmitate injection andpaliperidone extended-release tablets） on long-term cure rate, remission rate, recurrence rate and rehospitalization rate for patientswith schizophrenia. Methods：60 cases, who orally took paliperidone extended-release tablets at 3-12mg/ d for 6 weeks and were un-der a stable condition, were randomly divided into paliperidone palmitate injection group （long-acting infection group） and paliperi-done extended-release tablets group （oral group）. These cases were treated for 12 months. The efficiency, safety, social functions andmedication satisfaction degrees of the two groups were assessed by using positive and negative syndrome scale （PANSS）, treatment e-mergent symptom scale （TESS）, personal and social performance scale （PSP） ans medication satisfaction questionnaire （MSQ） at 0month （baseline） and 3, 6, 9, and 12 months after the treatment. Further, the cure rates, remission rates, drug withdrawal rates, re-currence rates and rehospitalization rates of the two groups were compared. Results： At the endpoint of the study, the long-term curerate （33. 7%） and remission rate （61. 0%） of long-acting injection group were higher that those （14. 3% and 54. 8%） of oral group（P〈0. 05）. The PANSS and PSP scores of long-acting injection group were higher that those of oral group （P〈0. 05）. The two formu-lations were both safe and endurable （P〉0. 05）. MSQ showed that the satisfaction degree of long-acting injection group was higherthat that of oral group （P〈0. 05）. There was 1 case of drug withdrawal, 1 case of recurrence, and no rehospitalization cases, whereasthere was 8 cases of drug withdrawal at different degrees, 5 cases of recurrence, and 1 case of rehospitalization （P〈0. 05）. Conclu-sions： Paliperidone palmitate injection in the treatment of the patients with schizophrenia can obviously improve the cure rate and re-mission rate, reduce the drug withdrawal rate, recurrence rate and rehospitalization rate, and is safe.