不同药物治疗老年精神分裂症疗效及对糖脂代谢的影响

Effects of different drugs on treatment of elderly schizophrenia and on glucolipid metabolism

目的探讨奥氮平、阿立哌唑与喹硫平治疗老年精神分裂症的临床疗效以及对患者糖脂代谢的影响。方法选择我院收治的老年精神分裂症患者99例,随机分为A、B、C 3组各33例,分别给予奥氮平、阿立哌唑或喹硫平治疗。对3组治疗前1 d和治疗2 w及8 w时的阳性和阴性症状量表(PANSS)评分、糖脂代谢变化进行比较。结果治疗后3组PANSS评分总分及各因子得分均较治疗前下降(P<0.05),且治疗时间越长,下降越显著(P<0.05)。而3组间比较无统计学差异(P>0.05)。治疗8 w时,A、C两组除高密度脂蛋白外的其他糖脂代谢指标均显著高于治疗前(P<0.05),而B组与治疗前比较无显著变化(P>0.05)。B组不良反应发生率明显低于A组及C组(P<0.05)。结论奥氮平、阿立哌唑与喹硫平治疗老年精神分裂症患者疗效相当,但奥氮平和喹硫平对患者糖脂代谢影响较大,而阿立哌唑无显著影响,且不良反应发生率低。

Objective To explore the effects of olanzapine, aripiprazole and quetiapine on the treatment of elderly schizophrenia and on glucolipid metabolism. Methods A total of 99 elderly patients with schizophrenia admitted to our hospital were selected and randomly divided into three groups （n=33, respectively）. Groups A, B and C were treated with olanzapine, aripiprazole and quetiapine respectively. The PANSS scores and changes in glucolipid metabolism one day before the treatment and two and eight weeks after the treatment were compared, llemtl~ The total PANSS scores and the scores of all factors in the three groups after the treatment dropped greatly （P 〈 0.05）; and, the longer the treatment time is, the more significant the decrease will be （P 〈 0.05）. There was no significant difference among the three groups. Eight weeks after the treatment, except for HDL, the other glucolipid metabolism indicators in groups A and C were significantly higher than those before the treatment（P 〈 0.05）; such indicators in group B showed no obvious change （P 〉 0.05）. The incidence of adverse reactions in group B was much lower than that in groups A and C （P 〈 0.05）. ~hmion Olanzapine, aripiprazole and quetiapine have equivalent effects on the treatment of elderly schizophrenia, but olanzapine and quetiapine impose greater impact on the patients＂ glucolipid metabolism, while aripiprazole has not any significant impact and the incidence of adverse reactions is lower if aripiprazole is applied.