齐拉西酮联合小剂量奎硫平治疗首次发病老年精神分裂症患者的对照研究

Control study of ziprasidone combined with low-dose quetiapine in first-episode elderly schizophrenia patients

目的:探讨齐拉西酮联合小剂量奎硫平及齐拉西酮单药治疗首次发病的老年精神分裂症患者的疗效及对糖脂代谢的影响。方法:72例首次发病的老年期精神分裂症患者随机分为齐拉西酮联合小剂量奎硫平组(研究组)和齐拉西酮组(对照组)各36例,疗程8周。治疗前后给予阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI-SI)及治疗中出现的症状量表(TESS)评定,比较两组体质量、血糖及血脂的变化。结果:治疗后两组PANSS及CGI-SI总分均较治疗前明显下降(P均<0.01);且研究组减分明显多于对照组(P<0.05或P<0.01);总有效率研究组(88.9%)明显高于对照组(77.8%)(Z=2.101,P<0.05)。治疗后两组血糖及血脂水平无明显变化且两组间差异无统计学意义;研究组体质量较治疗前及对照组明显增加(P均<0.05);两组TESS评分和药物不良反应发生率比较差异无统计学意义。结论:齐拉西酮联合小剂量奎硫平治疗首次发病的老年精神分裂症患者的疗效优于单用齐拉西酮治疗,对血糖、血脂影响较小,但导致体质量的增加。

Objective： To explore the curative effect and influence on glucose and lipid metabolism of ziprasidone plus low-dose quetiapine on first-episode aged patients with schizophrenia. Method：Seventy-two first-episode aged patients with schizophrenia were diveded into study group （ treated with ziprasidone combined to low-dose quetiapine） and control group （ treated with ziprasidone） for 8 weeks. Before and after treatment, the patients were evaluated by positive and negative syndrome scale （PANSS）, the clinical global impression scale （CGI-SI） and treatment emergent symptom scale （TESS） ; and their body weight, levels of blood glucose and blood lipid were detected and compared. Results： After treatment, the scores of PANSS, CGI-SI in the two groups were significantly decreased than before treatment （ all P 〈 0.01 ） ;and the deduction in study group were significantly more than those in control group （P 〈0.05 or P 〈0.01 ） ;the total efficiency in the study group （88.9%） was significantly higher than the control group （77.8%） （ Z = 2. 101, P 〈 0.05 ）. After treatment, the levels of blood glucose and lipid of the two groups showed no significant change, and no significant difference between the two groups ;the body weight in the study group was significantly increased than before treatment and the control group （ all P 〈 0.05）. The scores of TESS and incidence of adverse drug reactions between the two groups were no statistically significant. Conclusion： The curative effect of ziprasidone combination with lowdose quetiapine on first onset elderly patients with schizophrenia is better than ziprasidone. The effect of blood glucose and blood lipid are small, but leads to increased body mass.