影响氟哌啶醇治疗精神分裂症疗效因素的分析

Analysis of factors affecting the clinical response of haloperidol in the treatment of schizophrenia.

为了进一步探讨影响氟哌啶醇（ＨＬ）治疗精神分裂症疗效的因素，对病程＜５年的３０例住院偏执型精神分裂症患者，以ＨＬ０．２０ｍｇｋｇ－１ｄ－１固定剂量治疗６周，以简明精神病评定量表、阳性症状评定量表、阴性症状评定量表（ＳＡＮＳ）评定疗效，以药物不良反应量表评定治疗副反应，放射免疫法测定药物浓度。结果：药物不良反应与临床疗效呈显著负相关，疗效好的患者游离氟哌啶醇血浆浓度反而较低。ＳＡＮＳ因子４（兴趣减少／社交活动减少）、因子５（注意障碍）的评分在治疗６周后比４周时有上升趋势。提示神经阻滞剂治疗造成的不良反应，会加重患者的某些阴性症状，最终导致总的临床疗效不满意。

The aim of this study was to make a further investigation on the factors possibly affecting the efficacy of haloperidol in the treatment of schizophrenia. 30 hospitalized paranoid schizophrenic patients were treated with haloperidol (HL). The dosage was 0.20 mg·kg -1 /d for 6 weeks. The clinical response was evaluated with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms (SANS).The side effects of HL therapy was measured with the Treatment Emergent Symptoms Scale. Our study indicated that the side effects of HL therapy were negatively correlated with clinical response while the free haloperidol plasma concentration in the group with marked improvement was much lower than that in the group showing resistant response. The scores of SANS factor 4 (ahendonia ascocialty )and factor 5 (attention) tended to increase when they were compared with the scores at the end of 4 weeks.It was considered that the unwanted effect induced by the neuroleptic might aggravate the patients negative symptoms and interfere with the final assessment of the clinical response.