齐拉西酮与氯氮平对精神分裂症患者疗效及糖脂代谢和生活质量的影响

Influences of ziprasidone and clozapine on efficacy,glucolipide metabolism and quality of life of schizophrenia

目的：探讨齐拉西酮与氯氮平治疗精神分裂症的临床疗效以及对患者糖脂代谢和生活质量的影响。方法将72例精神分裂症患者随机分为两组，每组36例，观察组口服齐拉西酮治疗，对照组口服氯氮平治疗，观察12周。治疗前后采用阳性与阴性症状量表评定临床疗效，生活质量综合评定问卷评定生活质量，同时检测空腹血糖、胰岛素、低密度脂蛋白及体质量指数的变化。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（ P ＜0．01），同期两组间评分比较差异均无显著性（P＞0．05）。观察组治疗后生活质量综合评定问卷总分及躯体、心理、社会功能维度评分均较治疗前显著升高（P＜0．01），且显著高于对照组（P＜0．01）；对照组治疗后仅心理维度评分较治疗前显著升高（P ＜0．01）。观察组治疗后空腹血糖、胰岛素、低密度脂蛋白及体质量指数水平与治疗前比较差异均无显著性（P＞0．05），对照组均较治疗前显著升高（P＜0．05或0．01），观察组治疗后各项指标水平均显著低于对照组（P ＜0．05或0．01）。结论齐拉西酮与氯氮平治疗精神分裂症患者疗效相当，但齐拉西酮对患者糖脂代谢代谢影响较小，且能显著提高患者的生活质量。

Objective To explore the efficacy of ziprasidone and clozapine in schizophrenia and their influ‐ences on glucolipide metabolism and quality of life .Methods Seventy‐two schizophrenics were randomly divided into two groups of 36 ones each ,observation group took orally ziprasidone and control did clozapine for 12 weeks .Efficacies were assessed with Positive and Negative Syndrome Scale （PANSS） before and af‐ter treatment ,qualities of life with the Generic Quality of Life Inventory‐74 （GQOLI‐74） ,and the changes of blood‐fasting sugar （BFS） ,insulin ,low density lipoprotein （LDL） and body mass index （BMI） detected at the same time .Results After treatment the total and each factor scores of the PANSS of both groups lowered more significantly compared with pretreatment （P〈 0 .01） ,there were no significant group differ‐ences （P〉 0 .05） .The total ,physical ,psychological and social functioning score of the GQOLI‐74 height‐ened more significantly in observation group compared with pretreatment （P〈 0 .01） and those were signif‐icantly higher than in control group （P〈 0 .01） ;only psychological dimension score heightened more sig‐nificantly compared with pretreatment in control group （P 〈 0 .01） .There were no significant differences in BFS ,insulin ,LDL and BMI levels between post‐ and pre‐treatment in observation group （P 〉 0 .05） , those heightened more significantly after treatment compared with pretreatment in control group （P〈 0 .05 or 0 .01） ,and those after treatment were significantly lower in observation than in control group （P〈 0 .05 or 0 .01） .Conclusion Ziprasidone and clozapine have equivalent efficacy in schizophrenia ,but the former has less influence on glucolipide metabolism and could notably improve patients’ quality of life .