阿立哌唑与帕利哌酮治疗孤独症伴精神发育迟滞疗效比较

Efficacy of Aripiprazole or Paliperidone in the Treatment of Autism with Mental Retardation: A Comparative Study

目的比较阿立哌唑与帕利哌酮治疗孤独症伴精神发育迟滞的临床疗效及安全性。方法选取医院门诊及重庆市儿童福利院2018年7月至2018年12月收治的孤独症伴精神发育迟滞发育迟滞患儿42例,按随机数字表法分为阿立哌唑组和帕利哌酮组,各21例。两组患儿口服相应药物,均持续治疗12周。结果与治疗前比较,两组患儿治疗2周及12周后阳性与阴性症状量表(PANSS)总分、阴性症状积分、阳性症状积分、基本病理评分显著降低(P<0.05),且治疗2周后,阿立哌唑组患儿阳性症状积分、锥体外系副作用量表(RSESE)评分均显著低于帕利哌酮组(P<0.05);阿立哌唑组与帕利哌酮组总有效率及不良反应发生率相当(85.71%比80.95%,23.81%比28.57%,P>0.05);阿立哌唑组患儿治疗前后催乳素水平无显著差异(P>0.05),帕利哌酮组患儿治疗后催乳素水平显著升高(P<0.05)。结论阿立哌唑治疗孤独症伴精神发育迟滞的疗效与帕利哌酮相当,对催乳素影响较小,且不增加不良反应。

Objective To compare the clinical efficacy and safety of aripiprazole or paliperidone in the treatment of autism with mental retardation.Methods Totally 42 autistic patients with mental retardation admitted to outpatient department in our hospital and Chongqing Children's Welfare Institute from July 2018 to December 2018 were selected and divided into the aripiprazole group and the paliperidone group by the random number table method,21 cases in each group.The children patients in the two groups were treated with corresponding drugs orally for 12 weeks.Results Compared with those before treatment,the total score of Positive and Negative Syndrome Scale(PANSS),score of negative syndrome scale,score of positive syndrome scale and score of basic pathology in the two groups were significantly decreased(P<0.05)after 2,12 weeks of treatment.The score of positive syndrome scale and Rating Scale for Extrapyramidal Side Effects(RSESE)in the aripiprazole group were significantly lower than those in the paliperidone group after 2 weeks of treatment.The total effective rate and incidence of adverse reactions in the aripiprazole group were similar to those of the paliperidone group(85.71%vs.80.95%,23.81%vs.28.57%,P>0.05).There was no significant difference in the level of prolactin before and after treatment in the aripiprazole group(P>0.05),while the level of prolactin in the paliperidone group were significantly increased after treatment(P<0.05).Conclusion Aripiprazole has the same efficacy as paliperidone in the treatment of patients with autism and mental retardation.However,a riprazole has little effect on prolactin without increasing the adverse reactions.