氯氮平治疗难治性精神分裂症的效能及相关因素

Screening and evaluation of related factors among refractory schizophrenia treated with clozapine

为探讨氯氮平（ＣＬＺ）治疗难治性精神分裂症的效能及相关因素，将符合研究标准的患者共４９例进行为期６周ＣＬＺ治疗。结果显示，ＣＬＺ起效快，不仅对阳性症状有效，对阴性症状也有效。对可能影响ＣＬＺ疗效的因素进行多元回归分析发现，如下因素依次对疗效产生积极的影响：（１）治疗前简明精神病评定量表的焦虑抑郁因子分高；（２）治疗前阴性症状量表的注意障碍因子分高而思维贫乏因子分低；（３）治疗前阳性症状量表的阳性思维障碍因子分低；（４）本次治疗前的住院次数少；（５）家族史阴性；（６）首次住院年龄大。提示氯氮平对难治性精神分裂症不失为有效和相对安全的药物。

The trial was designed to study the efficacy and related factors of clozapine in the treatment of refractory schizophrenic inpatients. Forty nine subjects entered a 6 week prospective trial. It was found that both negative and positive symptoms were improved in the patients after 6 week clozapine treatment. The multiple regression analysis showed that the factors having positive influence on therapeutic efficacy of clozapine were as follow: (1) High baseline anxiety/depression subscore on BPRS; (2) High baseline attention disorder subscore and low thought poverty subscore on SANS; (3) Low baseline positive thought disorder subscore on SAPS; (4)Fewer previous admissions; (5)Negative family history; (6) Relatively older at first admission. The results suggest that clozapine is an effective and relatively safe antipsychotic for refractory schizophrenic patients.