氯丙嗪与氯氮平对精神分裂症患者血清肌酸磷酸激酶影响的对比研究

目的 探讨氮丙嗪与氯氮平对精神分裂症患血清肌酸磷酸激酶(CPK)活性的影响。方法 以单用氯丙嗪和单用氯氮平各治疗50例精神分裂症患，于治疗前、治疗4w末和8w末分别进行CPK检测，观察两组血清CPK的动态变化，同时以简明精神病量表(BPRS)评定其病情严重度，于8w末以副反应量表(TESS)评定副反应。同期选取本地区无精神病和精神病家族史的健康体检69名为对照组。结果 (1)精神分裂症在发病期的CPK活性极显高于对照组(P＜0．01)，经氯丙嗪或氯氮平治疗后显下降；(2)经治疗CPK值逐渐下降并与BPBS总分的下降相平行，但氯氮平组的CPK值在4w末和8w末均显高于氯丙嗪组且稍高于正常组；(3)在BPRS减分率相当的情况下，氯氮平组的副反应较氯丙嗪组严重，这在一定程度上影响着患血清CPK水平。结论 精神分裂症患在发病期的CPK活性显升高，与病情严重度相平行，氯氮平对CPK活性有一定的影响，与其较严重的副反应有关。

Effects of chlorpromazine and clozapine on serum creatine phosphokinase in schizophrenia

Objective To investigate the effects of chlorpromazine and clozapine on the activity of serum creatine phophokinase ( CPK) in schizophrenics. Methods Fifty schizophrenics were treated with single chlorpromazine and another fifty with clozapine. The serum CPK levels were tested at pretreatment and at the ends of 4th and 8th weeks of treatment , and meantime dynamic changes of serum CPK were observed ; the severity of patients was evaluated with BPRS, side effects were evaluated with TESS, at the end of 8th week of treatment. Sixty - nine healthy persons without psychosis and family history were regarded as normal control. Results The serum CPK levels of the patients during the onset period were significantly higher than that of control group ( P < 0.01) , and obviously decreased after treatment with chlorpromazine or clozapine. After treatment the serum CPK levels gradually decreased, which were in accordance with the decrease of the total score of the BPRS. At the ends of 4th and 8th weeks of treatment, the serum CPK levels of clozapine group were significantly higher than that of chlorpromazine group and slightly above that of control group. In the context of the same score reduction rate of BPRS, the side effects in clozapine group were more serious than that in chlorpromazine group, to a certain extent which affected the serum CPK levels. Conclusion During the onset period of schizophrenia, the serum CPK levels significantly increased and were parallel with the severity of patient' s conditions. Clozapine has a certain effect on the activity of serum CPK , which is correlated with its more serious side - effects.