阿立哌唑治疗急性复发精神分裂症29例

Efficacy and safety of aripiprazole in the treatment of acute relapsed schizophrenia

目的:探讨新型抗精神病药物阿立哌唑治疗急性复发精神分裂症的有效性和安全性。方法:随机入组症状急性恶化或复发的精神分裂症患者30例(脱落1例),纳入分析29例(男15例,女14例),采用阿立哌唑治疗,剂量为(14．4±9．2)mg·d-1,临床观察6周。采用阳性症状与阴性症状量表(PANSS)评定疗效,用不良反应症状量表(TESS)、血生化指标和心电图的改变评价治疗的安全性。结果:①治疗1周后,PANSS阳性、阴性症状分和总分均显著下降(P<0．05);治疗6周后PANSS各分值(阳性症状分为15．5±6．1,阴性症状分为15．1±7．0,总分为60．4±18．1)与基线水平(阳性症状分为26．8±7．1,阴性症状分为22．1±8．4,总分为96．4±21．0)差异显著(P<0．01)。②经6周治疗,基本痊愈6例(20．7％),好转共12例(41．4％),症状无显著变化11例(37．9％),1例患者病情有恶化。③治疗过程中,所有患者TESS总分平均值(2．0±2．3),其中12例患者评分一直为0;主要表现为失眠、静坐不能、食欲减退、便秘、视物模糊。6周的观察中未发现阿立哌唑导致的体重显著增加和心电图的明显改变。结论:阿立哌唑对急性复发的精神分裂症有良好的疗效,而且不良反应较小。

Objective： To evaluate the efficacy and safety of aripiprazole in the patients with acute relapsed schizophrenia. Methods： Thirty patients with acute worsening or relapsed schizophrenia were administered aripiprazole （ 14.4 ± 9.2）mg·d^-1 for 6 weeks. The efficacy and safety of the therapy was evaluated based on the outcomes of Positive and Negative Symptoms Scale （PANSS） , Treatment Emergent Symptoms Scale （TESS） and the status of blood biochemistry and electrocardiogram pre- and post-treatment. Results： The patients initiated significant reductions of positive, negative and total PANSS after the 1-week treatment （P 〈 0. 05）. The positive, negative and total PANSS patients had after the 6-week treatment gave significant reductions compared to the baseline values （ 15.5 ± 6. 1 versus 26.8 ± 7.1, 15.1 ±7.0 versus 22. 1 ±8.4 and 60.4 ± 18. 1 versus 96.4 ±21.0）, respectively （P 〈0.01）. The 6-week course of the therapy provided a cure rate of 20.7% （6/29） , improvement of 41.4% （12/29） and nonimprovement of 37.9% （11/29）. The average TESS score was 2.0 ± 2.3. The major adverse events included insomnia, irritation, lost of appetite, constipation and blurred vision. The patients showed no weight gain and ECG abnormality after the 6-week treatment. Conclusion： Aripiprazole offered a better option for patients with acute relapsed schizophrenia.