帕利哌酮治疗首发精神分裂症临床疗效观察

Clinical efficacy of paliperidone in treatment of first episode schizophrenia

目的:调查研究帕利哌酮治疗首发精神分裂症的临床疗效及安全性。方法:收集2012年1-6月在我院门诊就诊及住院的76例首发精神分裂症患者,随机分为帕利哌酮组和利培酮组,每组38例,观察8周。应用阳性与阴性症状量表(PANSS)、个人和社会功能量表(PSP)评价临床疗效和社会功能,应用副反应量表(TESS)评价不良反应。结果:共72例患者完成随访,帕利哌酮组35例,利培酮组37例。治疗4周末帕利哌酮组PANSS各项减分率更明显,两组差异有显著性(P<0.05);治疗8周末时两组PANSS总分、阳性症状分、阴性症状分和一般精神病理症状分均较治疗前有显著下降(P<0.01);帕利哌酮组治疗有效率为82.9%,利培酮组治疗有效率为86.5%,疗效差异无显著性(P>0.05);治疗8周末时两组PSP值有不同程度提高,帕利哌酮组提高更明显,两组间比较差异有显著性(P<0.05)。两组均未发生严重不良反应。结论:帕利哌酮治疗首发精神分裂症疗效与利培酮无明显差异,但起效快,安全性高,能有效改善社会功能。

Objective To investigate the clinical efficacy and safety of paliperidone in treatment of first episode schizophrenia. Methods The data of 76 cases of patients with schizophrenia from January 2012 to June 2012 in our hospital were collected. The patients were randomly divided to paliperidone group and risperidone group, 38 cases per group, were observed for 8 weeks. We used positive and negative symptoms scale （PANSS）, personal and social function scale （PSP） to assess clinical efficacy and social function, used treatment emergent symptom scale （TESS） to evaluate adverse reactions. Results All of 72 patients finished the follow up,35 cases in paliperidone group, 37 cases in risperidone groups. After 4 weeks, score-reducing rate of PANSS in paliperidone group were all the more obvious, there was significant difference in two groups （P 〈 0.05）. After 8 weeks, aggregate score of PANSS, points of positive symptoms, points of negative symptoms and points of general psychiatric symptoms were obviously decreased as compared with that before treatment in two groups （P 〈 0.01 ）. The effective rates were 82.9% and 86.5%, in paliperidone group and risperdal group （P 〉 0.05） ; After 8 weeks, PSP value increased in two groups , paliperidone group was more apparent （P 〈 0.05）. There were no serious adverse reactions in both groups. Conclusion There are no obvious difference between paliperidone and risperidone in treatment of first episode schizophrenia, but paliperidone have the effect to fast, high safety features, and effectively improve the social function