阿立哌唑对双向情感障碍患者的 D2受体和5-HT1A 受体的部分激动作用及对5-HT2A 受体的拮抗疗效分析

Aripiprazole in patients with bipolar disorder D2 receptor and 5 -HT1A receptor partial agonists and analysis of 5-HT2A receptor antagonism

目的：探讨阿立哌唑对双向情感障碍患者的 D2受体和5-HT1A 受体的部分激动作用及对5-HT2A受体的拮抗作用。方法选择2013年1月至2015年1月在浙江省平阳县中医院进行治疗的双向情感障碍患者113例，按照患者的入院顺序分为阿立哌唑组47例，对照组66例。对照组给予文拉法新（怡诺思）治疗，阿立哌唑组在此基础上加用阿立哌唑进行治疗，比较两组治疗前后抑郁自评量表（SDS）、贝克-拉范森躁狂量表（BRMS）评分及治疗效果。结果两组患者治疗后 SDS、BRMS 评分均有所降低，与治疗前相比较，差异均有统计学意义（t ＝31．3587、36．1207，均 P ＜0.05）；且阿立哌唑组患者较对照组患者而言降低更加明显，两组患者治疗后 SDS[（31．8±4．3）比（28．7±3.6）]、BRMS 评分[（6．5±0．2）、（5．5±0．2）]比较差异均有统计学意义（t ＝4．1107、26．1970，均P ＜0．05）；阿立哌唑组治疗效果明显优于对照组，其总有效率高达97．9％，而对照组仅为89．4％，两组患者的治疗效果比较差异有统计学意义（u ＝3．3659，P ＝0．0008）；阿立哌唑组嗜睡、恶心、呕吐、焦虑及心跳过速等不良反应明显低于对照组，且两组患者在恶心、呕吐焦虑及总不良反应方面比较差异有统计学意义（均 P ＜0.05）。结论阿立哌唑对双向情感障碍患者 D2受体和5-HT1A 受体有部分激动作用，对5-HT2A受体有拮抗作用，能有效改善患者治疗效果，减少不良反应发生率。

Objective To explore the efficacy of aripiprazole in patients with bipolar disorder D2 receptor and 5 -HT1A receptor partial agonists and analyze 5 -HT2A receptor antagonism.Methods From January 2013 to January 2015,113 patients came to our hospital for treatment of bipolar disorder,in accordance with the order of admission,were divide into aripiprazole group （47 cases）and control group （66 cases）.The control group was given venlafaxine,aripiprazole group was given aripiprazole treatment on the basis of the control group.SDS,BRMS score and therapeutic effect were compared between the two groups before and after treatment.Results The SDS,BRMS scores were decreased after treatment in the two groups,compared with before treatment,the differences were statisti-cally significant （t =31.3587,36.1207;all P 〈0.05 ）;and the aripiprazole group decreased more significantly than the control group,the SDS,BRMS scores of the two groups after treatment had statistically significant differences [SDS （31.8 ±4.3）points vs （28.7 ±3.6）points,BRMS （6.5 ±0.2）points vs （5.5 ±0.2）points,t =4.110 7,26.197 0, all P 〈0.05 ].The total effective rate of the aripiprazole group was 97.9%,which was significantly higher than 89.4% of the control group （u =3.365 9,P =0.000 8）.The incidence rate of adverse reactions such as nausea, vomiting,drowsiness,anxiety and heart rate in the aripiprazole group was significantly lower than the control group （all P 〈0.05 ）.Conclusion Aripiprazole for bipolar disorder patients with D2 receptor and 5 -HT1A receptor has partial agonism,of 5 -HT2A receptor with role constraints,can effectively improve the effect of treatment of patients,reduce the incidence of adverse reactions.