3种抗精神病药治疗首发精神分裂患者疗效的6个月随访

6-month follow-up on efficacy of three kinds of atypical antipsychotics in the first episode patients with schizophrenia

目的:通过随访,比较非典型抗精神病药的疗效和安全性,并就其对于服药依从性和社会功能的影响进行对比。方法:采用阳性和阴性症状评定量表(PANSS)、UKU不良反应量表、个人与社会表现量表(PSP)、服药态度量表(DAI)在基线和治疗6个月末对103例患者进行评估。结果:①6个月末,奥氮平组PANSS一般病理学量表总分较之阿立哌唑组显著降低(P<0.05),3种药物组PANSS阳性症状总分、PANSS阴性症状总分和PANSS总分均无显著性差异。②6个月末3种药物组DAI、PSP评分均无显著性差异。③利培酮组肌张力障碍及震颤发生率较高,分别为26.5%和20.6%。奥氮平组思睡/镇静、口干、便秘及体质量增加发生率均显著高于其他组(P<0.01)。结论:3种非典型抗精神病药物对于首发精神分裂症患者的阳性症状和阴性症状的改善作用相当,在改善服药依从性及社会功能方面作用差别不明显。

Objective： To compare the effectiveness and safety of the atypical antipsychotics, and to ex- plore their influences on medication adherence and social function. Method：All the subjects were assessed using positive and negative syndrome scale （PANSS） , Udvalg for Kliniske Undersogelser （UKU） side effect rat- ing scale,personal and social performance scale （PSP） and drug attitude inventory（ DAI-10 ） at baseline and the 6th month. Results： ①At the 6th month, PANSS general psychopathology scale scores were significantly lower in olanzapine group than in aripiprazole group （ P 〈 0.05 ）. There were no significant differences among all the three groups on PANSS positive scale scores, PANSS negative scale scores and PANSS total scores. ②At the 6th month, the three groups showed no significant differences on DAI scores and PSP scores. ③Risperidone had higher incidence of dysmyotonia （26.5%） and tremor （20.6%） ;side effects somnolence,dry mouth,constipa- tion and weight gain occurred more in olanzapin group than the other two group （ P 〈 0.01 ）. Conclusion： A- typical antipsychotics olazapine, risperidone and aripiprazole are similar in the treatment of first-episode schizo- phrenia patients ;they all can improve positive and negative symptoms, patients＇adherence and social function.