齐拉西酮与氨磺必利治疗急性期精神分裂症的疗效及对糖脂代谢影响比较

Comparison of the efficacy of ziprasidone and amisulpride in the treatment of acute schizophrenia and their effects on glucose and lipid metabolism

目的比较抗精神病药物齐拉西酮与氨磺必利治疗急性期精神分裂症患者的疗效及对糖脂代谢的影响。方法选择2017年3月-2018年12月山东省临沂市精神卫生中心符合ICD-10诊断标准的首发或复发急性期精神分裂症患者64例,采用随机数字表法分齐拉西酮组和为氨磺必利组,每组32例,比较2组治疗前、治疗第2周末、第4周末、第6周末、第8周末PANSS量表评分及空腹血糖、血脂水平。结果治疗第2周末和第8周末齐拉西酮组阳性症状评分低于氨磺必利组(P<0.05);治疗第4周末、第6周末2组阳性症状评分比较差异无统计学意义(P>0.05)。齐拉西酮组第4、6、8周末阴性症状评分高于氨磺必利组(P<0.05或P<0.01)。2组治疗前、治疗第2、4、6、8周末精神病理评分和总分比较差异无统计学意义(P>0.05)。治疗后第8周末,齐拉西酮组FBG、TC、TG、HDL-C、LDL-C与治疗前比较差异均有统计学意义(P<0.05);氨磺必利组FBG、TC、TG、HDL-C、LDL-C与治疗前比较差异无统计学意义(P>0.05)。结论齐拉西酮与氨磺必利治疗急性期精神分裂症患者的疗效相当,氨磺必利更利于改善阴性症状,齐拉西酮控制阳性症状起效更快,齐拉西酮对血糖、血脂代谢的影响更大。

Objective To compare the efficacy of ziprasidone and amisulpride in the treatment of patients with acute schizophrenia and their effects on glucose and lipid metabolism.Methods 64 patients with first-onset or recurrent acute schizophrenia who met the diagnostic criteria of ICD-10 in Linyi Mental Health Center of Shandong Province from March2017 to December 2018 were selected,and they were divided into the ziprasidone group(32 cases)and the amisulpride group(32 cases)by random number table,the PANSS scale scores and fasting blood glucose and blood lipid levels of the two groups were compared before treatment,on the second weekend,on the fourth weekend,on the sixth weekend,and on the eighth weekend.Results The positive symptom scores of the ziprasidone group at the second and eighth weeks of treatment were lower than those of the amisulpride group(P<0.05);There was no significant difference in the scores of positive symptoms between the 4 weeks and the 6 weeks of treatment(P>0.05).The ziprasidone group had higher negative symptom scores at4,6,and 8 weeks than the amisulpride group(P<0.05 or P<0.01).There was no significant difference in the psychopathological scores and total scores between the two groups before treatment and at the end of the treatment at 2,4,6,and 8 weeks(P>0.05).On the 8 weeks after treatment,the FBG,TC,TG,HDL-C,and LDL-C in the ziprasidone group were significantly different from those before treatment(P<0.05);There was no significant difference in FBG,TC,TG,HDL-C,and LDL-C in the amisulpride group compared with before treatment(P>0.05).Conclusion Zilacidone and amisulpride are equivalent in the treatment of patients with acute schizophrenia,amisulpride is more conducive to improving negative symptoms,zilacidone controls positive symptoms more quickly,and ziprasidone has a greater effect on blood glucose and lipid metabolism.