不同剂量阿立哌唑治疗儿童Tourette综合征的长期疗效及安全性研究

Study on the long-term efficacy and safety of different doses of aripiprazole in the treatment of children with Tourette's syndrome

目的探讨不同剂量阿立哌唑治疗儿童Tourette综合征的长期疗效及安全性。方法选取2012年2月至2016年2月在首都儿科研究所附属儿童医院神经科门诊接受阿立派唑治疗并长期随访的Tourette综合征患儿(68例)为研究对象,根据药物剂量不同分为<10 mg/d剂量组和10~15 mg/d剂量组各34例,采用耶鲁综合抽动严重程度量表(YGTSS)对患儿抽动严重程度进行评价;同时对两组患儿的YGTSS评分、复发及不良反应情况进行对比。结果10~15 mg/d剂量组患儿的总有效率(97.1%)明显高于<10 mg/d剂量组(79.4%),差异有统计学意义(P<0.05);10~15mg/d剂量组治疗后的YGTSS评分明显低于<10 mg/d剂量组,差异有统计学意义(P<0.05);<10 mg/d剂量组患儿服药体重增加明显少于10~15 mg/d剂量组(P<0.05)。结论大剂量阿立哌唑对多巴胺D2受体阻滞剂耐药的Tourette综合征有效,但是大剂量阿立哌唑的不良反应高于小剂量组。

Objective To study the long-term efficacy and safety of different doses of aripiprazole in the treatment of Tourette＇ s syndrome in children. Methods From February 2012 to February 2016, 68 cases with Tourette syndrome who were treated with long-term aripiprazole at the neurology outpatient were included into this study, according to the different treatment methods were divided into the 〈10 mg/d dose group and the 10-15 mg/d dose group（n=34）, the Yale Global Tic Se- verity Scale （YGTSS） were used to evaluate the children with Yale Global Tic Severity, YGTSS score, recurrence and adverse reaction of two groups of patients. Results The total efficiency of the 10-15 mg/d dose group （97.1%） was significantly higher than the 〈10 mg/d dose group （79.4%, P 〈 0.05）; YGTSS score of the 10-15 mg/d dose group were significantly lower than the 〈10 mg/d dose group （P 〈 0.05）; weight gain of the 〈10 mg/d dose group was less than the 10-15 mg/d dose group （P 〈 0.05）. Conclusion Large doses of aripiprazole on dopamine D2 receptor blocker resistant Tourette syndrome is effective, but large doses of aripiprazole adverse reactions is more than low-dose aripiprazole.