利培酮治疗首发精神分裂症疗效分析及对血清心肌标志物的影响

Change in serum cardiac markers of myoglobin of Risperidone after treatment of schizophrenia

目的:探讨利培酮对首发精神分裂症的疗效及对心肌标志物的影响,从而为临床合理用药提供给依据。方法:84例患者随机分为两组,分别接受利培酮高剂量和低剂量治疗,每例患者均于治疗前及治疗2、4、8周末进行阳性和阴性症状量表(PANSS)评分及肌酸磷酸激酶(CK)、肌酸激酶同功酶(CKMB)、肌红蛋白(MYO)和肌钙蛋白(cTnI)的测定,比较疗效及血清心肌标志物随时间的变化趋势。结果:随着治疗时间的延长,两组PANSS均呈现下降趋势,且在治疗2周起,两组PANSS与治疗前差异有统计学意义(P<0.05),但直至治疗8周,两组间差异才具有统计学意义(P<0.05);阳性得分:高剂量组治疗2周即与治疗前差异有统计学意义(P<0.05),对照组治疗4周出现统计学差异(P<0.05),但两组间差异始终无统计学意义(P>0.05);阴性得分:高剂量组治疗8周与治疗前差异有统计学意义(P<0.05),对照组治疗4周出现统计学差异(P<0.05),两组间差异始终无统计学意义(P>0.05);高剂量组总有效率92.86%,对照组90.48%,两组比较差异无统计学意义(P>0.05);CK:治疗2周后两组均明显上升,与治疗前差异有统计学意义(P<0.05),治疗4周时对照组恢复治疗前水平(P>0.05),而高剂量组治疗8周时才恢复正常(P>0.05);MYO和CK-MB:均治疗2周后升高(P<0.05),随着治疗的进行,MYO和CK-MB水平逐渐恢复,并在治疗8周时基本恢复治疗前水平(P>0.05);cTnI:两组治疗前及治疗过程中均未出现明显变化(P>0.05)。结论:精神分裂症利培酮治疗早期出现MYO和CK-MB变化,但随着治疗进行,该影响逐渐减弱,且此变化可能具有剂量依赖性。

Objective：To investigate the effect of cardiac markers and efficacy of risperidone on schizophrenia,so as to provide basis for clinical rational drug use.Methods A total of 84 patients were randomly divided into 2groups,respectively treated with risperidone in high dose and low dose,PANSS score and CK,CK-MB,MYO and cTnI were measured before treatment and 2,4,8weeks for each patient.Therapeutic effect and serum cardiac markers changes were compared with time.Results：The total score of PANSS,with the extension of treatment time,showed a downward trend.Since the treatment of 2weeks,significant difference was found compared with the one before treatment（P〈0.05）,but until the 8week of treatment,the difference between the two groups was statistically significant（P〈0.05）.The positive scores of the high dose group showed statistically significant difference 2weeks after treatment（P〈0.05）,while the difference of the low dose group treatment appeared since 4weeks after treatment（P〈0.05）,but there was no statistically significant difference between the two groups（P〈0.05）.The negative scores of the high dose group showed statistically significant difference 8weeks after treatment（P〈0.05）,while 4week for the low dose group（P〈0.05）,the difference between the two groups was not statistical significant（P〈0.05）.The total efficiency of the high dose group was 92.86%,and 90.48%in the low dose group,the differences between the two groups was not statistically significant（P〉0.05）.CK in two groups were significantly increased 2weeks after treatment,and there was statistically significant difference between two groups（P〈0.05）.Low dose group resumed 4weeks after treatment（P〈0.05）,while 8weeks for the high dose group（P〈0.05）.MYO and CK-MB were increased 2weeks after treatment（P〉0.05）.MYO and CK-MB levels were gradually restored,and restored as that before treatment in 8weeks（P〉0.05）.LKevel of cTnI in the two groups showed no obvious change before and during treatment（P〉0.05）.Conclusions：Risperidone treatment for schizophrenia causes MYO and CK-MB changes at first,but with treatment,the effect is gradually weakened,and this change may be in a dose dependent manner.