氯氮平治疗首发精神分裂症临床效应影响因素的筛选和评估

为筛选与氯氮平治疗效应相关的影响因素、指导临床合理选药，对３０例首发精神分裂症氯氮平治疗效应的影响因素进行筛选与评估。入组患者均按规定剂量给药，选用简明精神病评定量表（ＢＰＲＳ）、阴性症状评定量表（ＳＡＮＳ）、总体功能评定量表进行临床评定，动态观察治疗前及治疗后第１，２，４，８，１２周的病情变化，同时作血药浓度、催乳素和治疗前威斯康辛卡片分类测验（ＷＣＳＴ）测查。结果显示，治疗前ＢＰＲＳ的思维障碍因子分及激活性增高因子分高、基础催乳素水平低、首发年龄大、ＷＣＳＴ的保存记忆反应数多而完成第一套范畴数少、ＳＡＮＳ的注意障碍因子分高而思维贫乏因子分低等８项指标，对氯氮平治疗１２周时的疗效有正性影响。提示在首发精神分裂症的治疗中，可根据这８项影响因素合理选用氯氮平

Efficacy of clozapine and associated factor in the treatment of first episode schizophrenia

To screen factors associated with therapeutic efficacy of clozapine, 30 first episode schizophrenics were examined. Patients received fixed dose clozapine in a 12 week trial. Wisconsin Card Sorting Test (WCST) was tested before treatment. The Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS) and Global Assessment Function were tested and the levels of blood clozapine and prolactin were measured at the baseline and at the end of 1, 2, 4, 8, 12 week respectively. The results showed that the therapeutic effectiveness of clozapine was positively related with 8 factors, including the high scores of thought disorder and activation factor of BPRS before treatment, low basal prolactin level, old age of first episode, more perseverative responses and less trials to complete 1st category of WCST, high scores of attention disorder and low thought poverty factor of SANS before treatment. It suggested that clozapine might be selected reasonably in first episode schizophrenics according to above 8 factors.