氯氮平治疗首发精神分裂症临床效应及影响因素分析

An analysis of clinical efficacy on clozapine and its influence factors in the treatment of first-episode schizophrenia.

目的 探讨氯氮平治疗首发精神分裂症的效能及影响因素对指导临床用药有很大的实用性。 方法 3 0例首发精神分裂症病人均按规定剂量给药 ,选用简明精神症状评定量表 (BPRS)、阴性症状评定量表 (SANS)、临床总体印象量表 (CGI)、总体功能评定量表 (GAF) ,在治疗前及治疗第1、2、4、8、1 2周进行临床评定及血药浓度、催乳素 (PRI)检测 ,治疗前威斯康辛卡片分类测验 (WC ST)。 结果 氯氮平对首发精神分裂症的阳性、阴性症状均有显著的疗效 ,且起效迅速。此外发现血药浓度大于 40 0 μg/L、基础PRL水平低于 1 1 μg/L、WCST检查表现好的患者 ,选用氯氮平治疗有好的疗效。 结论 氯氮平可作为较好的一线药物 。

Objective To study clinical efficacy of clozapine and its influence factors on the treatment of first episode schizophrenic patients Methods 30 first episode schizophrenic patients were regularly treated with clozapine The rating scales of brief psychiatric rating scale (BPRS), scale for the assessment of negative symptoms (SANS) , clinical global impressions scale (CGI) and global assessment function(GAF) were used to assess the effects of clozapine, and blood drug concentration, prolactin and wisconsin card sorting test (WCST) were measured before and during the first, second, fourth, eighth, twelfth weeks following the treatment courses Rusults Positive and negative symptoms were markly rapidly improved In addition, the patients who had more 400 μg/L of blood drug concentration, less 11 μg/L of baseline prolactin levels and good WCST manifestations would have good response to clozapine treatment Conclusion Clozapine should be used widely to treat first episode schizophrenic patients as first line antipsychotic drugs