奥氮平治疗肝豆状核变性精神障碍近期临床疗效观察

Recent therapeutic effect observation on treating mental disorder due to hepatolenticular degeneration with olanzapine

目的观察奥氮平治疗肝豆状核变性精神障碍的近期疗效及不良反应。方法对32例住院患者均给予奥氮平治疗,起始量为2.5～5 mg,最大剂量为15 mg,共观察8周,使用简明精神病量表(BPRS)进行疗效评定,采用治疗副反应量表(TESS)进行疗后副反应评定,从疗前开始每2周评定1次。结果经观察8周后,32例中显著进步4例,进步24例,无效4例,显效率12.5%,有效率87.5%;治疗后2、4、6、8周与疗前BPRS总分比较差异均有统计学意义(P<0.01);副反应有睡眠增多、乏力、头晕、食欲及体质量增加和锥体外系症状等。结论奥氮平疗效显著、起效快、副反应较小,对于肝豆状核变性精神障碍是一种可以推荐使用的较为安全有效的治疗药物。

Objective To observe the recent effect and adverse reactions on treating mental disorder due to hepatolenticular degeneration with olanzapine.Methods All 32 cases of patients were received treatment with olanzapine,from 2.5mg to 5mg as initial dose,15mg as the maximum dose,with 8 weeks of treatment course,using brief psychiatric rating scale（BPRS） to evaluate therapeutic effect,and simultaneously using treatment emergent symptom scale（TESS） to assess the adverse reactions each 2 weeks.Results Through 8 weeks＇ observation,4 cases had significant improvement,24 cases had improvement,4 cases were inefficient,the tangible result rate was 12.5%,the effective rate was 87.5%,comparing to pre-therapy the 2nd,4th,6th,8th BPRS score all had statistical significant difference（P0.01） after treatment;the adverse reactions were somnolence,asthenia,dizziness,appetite and weight gain,extrapyramidal symptom and so on.Conclusion Olanzapine has significant and rapid effect,the adverse reaction is mild,for the mental disorders due to hepatolenticular degeneration,can be recommended as safe and effective therapeutic drug.