小剂量奥氮平与奋乃静治疗肝移植术后精神障碍的对照研究

Treatment of patients with mental disorders after liver transplantation by using olanzapine or perphenazine: a control study

目的观察小剂量奥氮平治疗肝移植术后精神障碍的疗效及安全性。方法选取肝移植术后2周内出现精神障碍患者78例,随机分为观察组(39例)和对照组(39例)。两组均在手术后给予相同基础药物治疗。观察组给予奥氮平片2.5 mg,每晚1次口服,每2 d增加2.5 mg,总剂量不超过10 mg。对照组给予奋乃静片1 mg,每晚1次口服。每2 d增加1 mg,总剂量不超过4 mg。分别在治疗前、治疗2周后,进行简明精神病(科)量表(BPRS)、不良反应量表(TESS)评分及体质量测定。结果观察组治疗前BPRS评分为(72.11±8.16),治疗2周后为(52.30±6.14),差异有统计学意义(P<0.05)。观察组治疗前BPRS评分为(71.26±8.01),治疗2周后为(65.50±7.22),差异无统计学意义(P>0.05)。治疗后,两组BPRS评分比较,差异有统计学意义(P<0.01)。两组均不良反应轻微,并可自行缓解。结论小剂量奥氮平治疗肝移植术后精神障碍疗效明确,安全可靠,有一定的临床应用价值。

Objective To observe the efficacy and safety of low dose olanzapine on patients with mental disorders after liver transplantation. Methods 78 cases of transplantation was divided into BPRS treatment group （n=39） and control group （n=39）. Olanzapine were given each night with the dose of 2.5mg and increased 2.5mg every other day till up to 10mg in treatment group. In control Group, perphenazine was given each night with the dose of 1mg and increased 1mg every other day till up to 4mg. BPRS and TESS were used to assess the efficacy and adverse events before and after two weeks of the treatment respectively. Results BPRS after treatment for two weeks decreased compared with before （72.11±8.16 vs. 52.30±6.14,P〈0.05）, but no significant difference was observed in control group （71.26±8.01 vs. 65.50±7.22, P〉0.05）. BPRS also decreased in treatment group compared with control group two weeks after LT （P〈0.05）.Adverse events in two groups were mild and can remiss simultaneously. Conclusion Low dose of olanzapine is an effective and safe drug in controlling mental disorder after liver transplantatation and is valuable in clinical application.