帕利哌酮与氯氮平对慢性精神分裂症血清唾液酸水平的影响

Influences of paliperidone and clozapine on serum sialic acid levels of chronic schizophrenia

目的：探讨帕利哌酮与氯氮平治疗慢性精神分裂症患者的临床疗效以及对血清唾液酸水平的影响。方法将67例住院男性慢性精神分裂症患者采用抛币法随机分为两组，帕利哌酮组（34例）予以帕利哌酮治疗，氯氮平组（33例）予以氯氮平治疗，观察8周。于治疗前后采用阳性与阴性症状量表、副反应量表评定临床疗效及不良反应，同时检测血清唾液酸水平的变化。结果治疗2周末起两组阳性与阴性症状量表总分及各因子分均治疗前显著降低（P＜0．01），治疗各时点两组评分比较差异无显著性（ P＞0．05）；治疗8周末帕利哌酮组总有效率为61．8％，氯氮平组为63．6％，两组比较差异无显著性（ P＞0．05）。治疗前后帕利哌酮组血清唾液酸水平无显著变化（P＞0．05），氯氮平组治疗2周及4周末较治疗前显著升高（P＜0．01），且显著高于帕利哌酮组（P＜0．01）。治疗8周末帕利哌酮组副反应量表评分显著低于氯氮平组（P＜0．01）。结论帕利哌酮与氯氮平治疗慢性精神分裂症疗效显著，总体疗效相当，但帕利哌酮对血清唾液酸水平无明显影响，安全性更高。

Objective To explore the influences of paliperidone and clozapine on the curative effect and se‐rum sialic acid levels of chronic schizophrenia .Methods Sixty‐seventy chronic schizophrenics were ran‐domly divided into two groups according to throwing coin ,paliperidone group （n=34） was treated with paliperidone and clozapine group （n=33） with clozapine for 8 weeks .Curative effects were assessed with the Positive and Negative Syndrome Scale （TESS） before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale （TESS） ,at the same time changes of serum sialic acid levels de‐tected .Results Since the edn of the 2nd week the total and each factor scores of both groups lowered more significantly compared with pretreatment （P〈0 .01） ,there were no significant group differences in those at each time point （P〉0 .05）;at the ends of the 8th week total effective arte was respectively 82 .5% in paliperidone and 74 .6% in clozapine group ,which showed no significant group difference （P〉0 .05） .Pre‐and post‐treatment sialic acid levels had no notable changes in paliperidone group （ P〉 0 .05 ） , those heightened more significantly at the end of the 2nd and 4th week in clozapine group （P〈0 .01） and were sig‐nificantly higher than in paliperidone group （P〈0 .01） .At the end of the 8th week the TESS score were significantly lower in paliperidone group than in clozapine group （P〈0 .01） .Conclusion Both paliperi‐done and clozapine are effective in chronic schizophrenia ,their total efficacies equivalent ,but paliperidone has less influence on serum sialic acid levels and higher safety .