奥氮平与利培酮治疗精神分裂症的效果及对血浆MiR-137、MiR-18b表达的影响

The effect of olanzapine and risperidone in the treatment of schizophrenia and its effect on the expression of MiR-137 and MiR-18b in plasma

目的探讨奥氮平治疗精神分裂症的临床效果及对患者血浆MiR-137、MiR-18b表达的影响。方法选取我院(2015.1～2017.4)治疗的90例精神分裂症患者,采用随机数字表法分为奥氮平组、利培酮组各45例,对比两组患者治疗后的阳性阴性症状量表(PANSS)评分、血浆微小RNA137(MiR-137)、微小RNA18b(MiR-18b)、血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及不良反应。结果治疗前,两组患者的PANSS评分差异无统计学意义(P>0.05);治疗4周、治疗8周,两组患者的PANSS总分较治疗前均显著的降低(P<0.05),但是两组间差异无统计学意义(P>0.05);治疗前,两组患者的MiR-137、MiR-18b、TG、TC、HDL-C、LDL-C水平差异无统计学意义(P>0.05);治疗后,两组患者MiR-137、MiR-18b水平较治疗前均显著的升高(P<0.05),奥氮平组患者的TG、TC、LDL-C水平高于利培酮组(P<0.05);治疗后,奥氮平组与利培酮组的临床疗效差异无统计学意义(P>0.05);奥氮平组的不良反应发生率26.67%高于利培酮组的8.89%(P<0.05)。结论奥氮平治疗精神分裂症的临床效果与利培酮差异不大,能有效的改善血浆MiR-137、MiR-18b水平,但是对患者的血脂代谢影响较大,不良反应发生率较高。

Objective To investigate the clinical effect of olanzapine in the treatment of schizophrenia and its effect on the expression of plasma MiR-137 and MiR-18 b in patients. Methods In our hospital(2015.1 ~ 2017.4)treatment of 90 cases of patients with schizophrenia were randomly divided into olanzapine group and risperidone group with 45 cases in each group,the two groups were compared after treatment of positive and negative symptoms scale(PANSS)score,plasma MiR-137,serum MiR-18 b,glycerol ester(TG),total three the cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and adverse reaction. Results Before treatment,there was no significant difference in PANSS score of two groups(P>0.05);after 4 weeks,8 weeks of treatment,two groups of patients with PANSS score before treatment were significantly decreased(P<0.05),but there was no significant difference between the two groups(P>0.05);before the treatment,no statistical significance in two groups MiR-137,MiR-18 b,TG,TC,HDL-C,LDL-C level difference(P>0.05);after treatment,the two groups of patients MiR-137,MiR-18 b levels were significantly increased(P<0.05),olanzapine group of patients with TG,TC and LDL-C were higher than that of risperidone group(P<0.05);after treatment,no significant differences in clinical efficacy olanzapine group and risperidone group(P>0.05);the incidence of adverse reaction of olanzapine group was 26.67%,which was higher than that of risperidone group 8.89%(P<0.05). ConclusionOlanzapine has little difference with risperidone in the treatment of schizophrenia,it can effectively improve plasma MiR-137 and MiR-18 b levels,but has a greater impact on blood lipid metabolism and a higher incidence of adverse reactions.