奥氮平与利培酮治疗老年精神分裂症的对照研究

目的：比较奥氮平与利培酮在老年精神分裂症方面的疗效与安全性。方法：选择46例住院老年精神分裂症患者为研究对象，随机分成两组，每组23例，分别给予奥氮平与利培酮治疗。并于治疗前及治疗第2，4，6，8周末进行精神病评定量表（BPRS）评定，比较两组治疗前后BPRS评分的变化。以BPRS评分的减分率为评定疗效标准，于治疗8周末评定临床疗效。采用副反应量表（TESS）于治疗2，4，6，8周末进行药物副反应评定；于治疗前和治疗8周末进行空腹血糖、胆固醇、甘油三酯测定，比较两组治疗前后血糖、血脂的变化。结果：治疗2，4，6，8周末两组的BPRS评分均逐渐下降，两组间评分比较，P〉0．05；组内比较，两组在第4周末比较，差异有显著性（P〈0．01，P〈0．05）；治疗8周末，奥氮平组显效率为74％，有效率为87％。利培酮组显效率为70％，有效率为83％，两组间比较差异无统计学意义（P〉0．05）。总体副反应发生率，奥氮平组出现副反应11例（48％），利培酮组14例（61％），两组比较P〉0．05；利培酮组锥体外系反应显著高于奥氮平组（P〈o．01），奥氮平组体重增加显著高于利培酮组（P〈0．05），其他副反应两组间比较P〉0．05。治疗8周末与治疗前相比，利培酮组空腹血糖、胆固醇、甘油三酯差异无统计学意义（P〉0．05）；奥氮平组差异均有显著性（P〈0．01，P〈0．05）。结论：奥氮平和利培酮对老年精神分裂症是安全、有效的，两者疗效相当，总的副反应发生率相近。利培酮锥体外系症状（EPS）突出，奥氮平引起血糖、血脂升高及体重增加明显。因此，在选择奥氮平和利培酮治疗老年精神分裂症时，应根据患者的病情、躯体状况、药物可能带来的风险来选择药物，优化老年精神分裂症的治疗。

Olanzapine and risperidone in the treatment of elderly schizophrenia

Objective：To compare olanzapine and risperidone in schizophrenia m the elderly etttcacy and salety. Methods：Of 46 cases hospitalized in our hospital for the elderly subjects with schizophrenia were randomly divided into two groups of 23 patients were given olanzapine and risperidone in the treatment. Respectively,before treatment and treatment of the first assessment of 2,4,6,8 weekend BPRS were compared before and after treatment BPRS score changes. BPRS score reduction in the rate for evaluating efficacy of sub-standard in the treatment of 8-week assessment of clinical efficacy. TESS scales used in the treatment of 2,4,6,8 weekend assessment of drug side effects;in the pre-treatment and treatment of eight weekends, fasting blood glucose,cholesterol,triglyceride measurements were compared before and after treatment blood glucose and blood lipid changes. Results ： After 2,4,6,8 weeks, the two groups BPRS scores were gradually decreased,and the rate difference between the two groups were not significantly （ P 〉 0. 0 5 ） , group comparison , both groups began to appear at the 4 th weekend significant difference （ P 〈0. 01, P〈 0. 05）, treatment of 8 weeks, olanzapine group were 74 % efficiency, efficiency of 87%, risperidone group were 70% efficiency,efficiency of 83% between the two groups There was no significant difference （P〉0.05）. The overall incidence of side effects,olanzapine group side effects occur in 11 cases （48%）,risperidone group, 14 cases （61 %）,the difference was no significant difference （P〉0.05）,risperidone group cone Department of response in vitro was significantly higher than the olanzapine group （P〈0.01）,olanzapine group gained weight significantly higher than the risperidone group （ P 〈 0. 0 5 ） , the other side was no significant difference between the two groups （ P 〉 0. 05）. Treatment of 8 weeks ,compared with those before treatment, risperidone fasting blood glucose,cholesterol, triglyceride were not significantly （ P 〉 0. 0 5 ） . Olanzapine group were there significant differences （ P 〈 0. 0 1 , P 〈 0. 05）. Conclusion：The olanzapine and risperidone in elderly schizophrenia is safe and effective,both very effective, the overall incidence of side effects similar to. Risperidone EPS prominent,olanzapine caused by blood sugar,blood lipids and weight gain increased significantly. Therefore,the choice of olanzapine and risperidone in the treatment of elderly schizophrenia should be based on patientrs condition,physical condition,medication may bring risk to the drug of choice to optimize the treatment of elderly schizophrenia.