帕利哌酮、阿立哌唑及利培酮治疗儿童青少年首发精神分裂症临床疗效的比较研究

Comparative study of the clinical efficacy of paliperidone,aripiprazole and risperidone in the treatment of firstepisode schizophrenia in children and adolescents

目的比较帕利哌酮、阿立哌唑及利培酮治疗儿童青少年首发精神分裂症的临床疗效。方法选取云南省精神病医院2018年8月—2019年8月收治的首发性精神分裂症儿童青少年85例,依据治疗方法不同分为甲组27例、乙组30例及丙组28例。甲组予以帕利哌酮治疗,乙组予以阿立哌唑治疗,丙组予以利培酮治疗。3组均持续给药3个月。比较3组治疗前后阳性与阴性症状量表(PANSS)评分、个人和社会功能量表(PSP)评分、糖代谢指标(空腹血糖、糖化血红蛋白)及脂代谢指标[三酰甘油、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)],并观察3组不良反应发生情况。结果治疗前,3组PANSS评分、PSP评分比较,差异无统计学意义(P>0.05);治疗后,甲组PNASS评分低于乙组、丙组,甲组、丙组PSP评分高于乙组(P<0.05)。治疗前后,3组空腹血糖、糖化血红蛋白、三酰甘油、HDL-C、LDL-C比较,差异无统计学意义(P>0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论与利培酮与阿立哌唑比较,帕利哌酮治疗儿童青少年首发精神分裂症更佳,可更有效改善临床症状,提高生活质量。

Objective To compare the clinical efficacy of paliperidone,aripiprazole and risperidone in the treatment of first-episode schizophrenia in children and adolescents.Methods A total of 75 cases of children and adolescents with firstepisode schizophrenia were selected from August 2018 to August 2019 in Yunnan Psychiatric Hospital,which were divided into group A(n=27),group B(n=30) and group C(n=28).Group A was treated with paliperidone,group B with aripiprazole and group C with risperidone.The drug was continuously administered for three months in all three groups.PANSS score,PSP score,glucose metabolism indexes(fasting blood glucose and glycosylated protein) and lipid metabolism indexes(triglyceride,HDL-C and LDL-C) of the three groups before and after treatment were compared,and the incidence of adverse reactions in the three groups were observed.Results Before treatment,there was no significant difference in PANSS score and PSP score among the three groups(P>0.05).After the treatment,the group A of PNASS scores were lower than group B and group C,and the group A and group C of PSP scores were higher than group B(P<0.05).Before and after treatment,the differences in fasting blood glucose,glycosylated protein,triglyceride,HDL-C and LDL-C among the three groups were not statistically significant(P>0.05).There was no significant difference in the incidence rate of adverse reactions among the three groups(P>0.05).Conclusion Compared with risperidone and aripiprazole,paliperidone is better for the treatment of first-episode schizophrenia in children and teenagers,and can more effectively improve the clinical symptoms and quality of life.