阿立哌唑与奥氮平对首发精神分裂症急性期疗效及对催乳素的影响

Therapeutic effects of aripiprazole and olanzapine on the patients with first-episode acute schizophrenia and their influence on plasma prolactin level

目的:研究奥氮平和阿立哌唑对首发精神分裂症患者急性期疗效及对血中催乳素(PRL)水平的影响。方法:65例首发精神分裂症患者分为奥氮平组42例[男21例,女21例;年龄(23.9±6.6)岁]和阿立哌唑组23例[男11例,女12例;年龄(23.7±7.2)岁]。分别给予奥氮平和阿立哌唑单药治疗4周。在基线和4周末,分别用阳性症状与阴性症状量表(PANSS)、临床总体印象量表-疗效总评(CGI-I)评定疗效。放射免疫法测定血清催乳素水平。结果:治疗4周末,奥氮平组PANSS总分(59±13)较基线(103±15)明显下降;阿立哌唑组PANSS总分(60±18)较基线(101±13)明显下降,差异具有统计学意义(P<0.01);治疗后,两组间CGI-I评分比较差异无统计学意义(P>0.05);治疗前后奥氮平组和阿立哌唑组之间PANSS量表阴性因子和一般精神病理因子分量表分的变化有统计学意义的差异(P<0.01)。奥氮平组治疗后催乳素(418±362)uIu/mL和基线(547±382)uIu/mL比较虽有所下降,但差异无统计学意义(P>0.05);阿立哌唑组治疗后催乳素(123±114)uIu/mL较基线(351±299)uIu/mL下降,差异具有统计学意义(P<0.01)。结论:阿立哌唑治疗首发精神分裂症患者急性期总体疗效和奥氮平相当。奥氮平对一般精神病理症状的改善优于阿立哌唑,阿立哌唑对阴性症状的改善优于奥氮平。阿立哌唑可能降低首发精神分裂症患者血催乳素水平。

AIM： To study the efficacy on first-episode acute schizophrenia treated with aripiprazole and olanzapine and the effect on plasma prolactin level.METHODS： 65 inpatients with first-episode acute schizophrenia were divided into either olanzapine group[n=42,M21,F21;age（23.9±6.6）year] or aripiprazole group[（n=23,M11,F12;age（23.7±7.2）year] for 4 week treatment.The plasma prolactin level,the Positive and Negative Syndrome Scale（PANSS） and clinical global impression-global improvement（CGI-I） were measured before and after 4 week treatment.RESULTS：The score of PANSS（59±13）after therapy in olanzapine group was significantly lower than that before therapy（103±15）（P0.01）.The score of PANSS（60±18）after therapy in aripiprazole group was significantly lower than that before therapy（101±13）（P0.01）.After therapy,there was no significant difference（P0.05） in the CGI-I score between the two groups.The difference of negative symptoms and general psychopathological sub-scale scores changing from base to end between the two groups was statistically significant（P0.01）.Compared with the prolactin baseline level（547±382） uIu/mL,the plasma prolactin level（418±362） uIu/mL in olanzapine group was significantly decreased after treatment,and there was no difference.Compared with the prolactin baseline level（351±299） uIu/mL,the plasma prolactin level（123±114） uIu/mL in aripiprazole group was significantly decreased after treatment,and there was significant difference（P0.01）.CONCLUSION： The therapeutic effects were similar in the aripiprazole and olanzapine group for first-episode acute schizophrenia.Olanzapine is better for the general psychopathological symptoms,and aripiprazole is better for the negative symptoms.Aripiprazole maybe decrease the plasma prolactin level of first-episode acute schizophrenia.