随访比较利培酮和氯氮平治疗精神分裂症病人出院后的疗效

A follow-up study on the efficacy of risperidone and clozapine in schizophrenic patients after discharge from hospi- tal

目的 评价利培酮和氯氮平在长期治疗精神分裂症病人中的疗效和经济费用。方法 对出院后精神分裂症病人进行半年随访,对照比较服用氯氮平或利培酮的病人的PANSS、SDSS、TESS及经济损失。结果 PANSS的反应缺乏因子在两组之间的差异具有极显著意义,利培酮对反应缺乏的疗效比氯氮平好,而对其它症状两药疗效相当。随访比较SDSS,发现利培酮能够更好地改善病人的社会功能。TESS资料显示此二药差异并不显著,但是副反应表现不同,利培酮锥外副反应出现率高达66.67％,随访时仍高达36.67％。计算病人出院后半年的直接、间接经济损失,结果显示利培酮组直接经济损失大,而氯氮平组间接经济损失大,但此二药总的经济损失相当。结论 利培酮治疗的最大优势在于能较好地改善社会功能,而总经济负担并未增加。

Objective To evaluate and compare the efficacy and economical expenses in the treatment of schizophrenic patients with risperidone and clozapine. Methods 60 cases of schizophreic inpatients treated with risperidone or clozap-ine respectively were followed up for 6 months, and the PANSS, SDSS, TESS, and economical expenses were assessed. Results The efficacy was similar in two groups, while the side effects was quite different. EPS rate of risperidone was as higher as 66. 7% during acute treatment, and remained at 36. 7% during follow-up period. The e-conomical expenses were similar in two groups: the direct expense of risperidone was higher than clozapine, while the indirect expense was lower. Conclusions The benefits of risperidone treatment are the better improvement in social function of the patients and the lower indrect economical expenses.