奥氮平或氯丙嗪治疗首发精神分裂症患者血清心肌酶谱比较

Comparison of myocardial enzymes in first-episode schizophrenics treated with olanzapine or chlorpromazine

目的探讨第二代抗精神病药奥氮平对首发精神分裂症患者血清心肌酶谱的影响。方法回顾性病史资料分析,比较奥氮平(92例)或氯丙嗪(73例)单药治疗的住院首发精神分裂症患者治疗前、治疗第4周、第8周的血清天冬氨酸氨基转氨酶(AST)、乳酸脱氢酶(LDH)及肌酸磷酸激酶(CK)及PANSS评分。结果除治疗第8周时奥氮平组血清CK浓度高于氯丙嗪组[中位数(四分位数)分别为138U/L(82U/L,210U/L)、83U/L(54U/L,124U/L)],差异有统计学意义(Z=2.517,P=0.012)外,2组间各时点心肌酶浓度无明显差异。各时点2组间PANSS评分差异无统计学意义。结论奥氮平治疗初期,首发精神分裂症患者CK浓度可能升高。

Objective： To explore the effect of olanzapine, the second generation of antipsychotic medication, on serum myocardial enzymes in patients with first - episode schizophrenia. Methods： Retrospective analysis was used to compare data from inpatients with first - episode schizophrenia treated with olanzapine （92 patients） or chlorpromazine （73 patients）. Serum levels of aspartate aminotransferase （ AST）, lactate dehydrogenase （LDH） and creatine kinase （CK） were tested and the efficaices of two antipsychoatics were measured with positive and negative syndrome scale （PANSS） before treatment , at 4 weeks and 8 weeks after treatment. The serum levels of AST, LDH and CK and the change of scores of PANSS were compared. Results：Mter 8 weeks of treatment, the serum level of CK in olanzapine group was signigicantly higher than that in chlorpromasine group [ the medians （the first quartiles, the third quartile） ：138U/L（82 U/L,210 U/L） vs. 83 U/L（54 U/L,124 U/L）, Z =2.517,P =0.012]. There was no significant difference of CK between two groups at baseline and 4 weeks after medication. There was also no significant difference of AST, LDH and scores of PANSS between the two groups at any timepoints. Conclusion： Olanzapine may elevate serum level of CK after short - term of therapy in patients with first - episode schizophrenia.