三种非典型抗精神病药对儿童青少年精神分裂症患者血脂、肝功能和认知功能的影响

Effects of Three Atypical Antipsychotics on Blood Lipid,Liver Function and Cognitive Function in Children and Adolescents with Schizophrenia

目的:探讨利培酮、阿立哌唑、奥氮平分别对儿童青少年精神分裂症患者肝功能、血脂和认知功能的影响。方法:选取2015年1月至2019年12月我院收治的84例儿童青少年精神分裂症患者,采用乱数表法随机分为阿立哌唑组(n=28,阿立哌唑治疗)、利培酮组(n=28,利培酮治疗)、奥氮平组(n=28,奥氮平治疗),均治疗8周,对比三组患者症状评分、血脂、肝功能、认知功能以及不良反应。结果:三组治疗8周后阳性与阴性症状量表(PANSS)评分整体比较无差异(P>0.05),三组治疗8周后PANSS评分均较治疗前降低(P<0.05)。奥氮平组、利培酮组治疗8周后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)高于阿立哌唑组,且奥氮平组高于利培酮组(P<0.05);奥氮平组、利培酮组治疗8周后高密度脂蛋白(HDL-C)低于阿立哌唑组,且奥氮平组低于利培酮组(P<0.05)。三组不良反应发生率整体比较无差异(P>0.05)。阿立哌唑组治疗8周后延迟回忆数、即刻回忆数、回忆总数、再认数评分均高于利培酮组、奥氮平组(P<0.05)。利培酮组治疗8周后ALT、AST、TBIL高于治疗前(P<0.05),利培酮组治疗8周后ALT、AST、TBIL高于阿立哌唑组、奥氮平组(P<0.05)。结论:利培酮、阿立哌唑、奥氮平应用于儿童青少年精神分裂症中,可获得相当的治疗效果,其中利培酮对肝功能影响较大,奥氮平对人体血脂影响较大,阿立哌唑对血脂、肝功能影响轻,改善认知功能效果优于利培酮、奥氮平。

Objective:To investigate the effects of risperidone,aripiprazole and olanzapine on liver function,blood lipid and cognitive function in children and adolescents with schizophrenia.Methods:84 cases of children and adolescents with schizophrenia who were admitted to our hospital from January 2015 to December 2019 were selected.They were randomly divided into aripiprazole group(n=28,aripiprazole treatment),risperidone group(n=28,risperidone treatment),olanzapine group(n=28,olanzapine treatment)by randomly number table method.All patients were treated for 8 weeks.Symptom score,blood lipid,liver function,cognitive function and adverse reactions of the three groups were compared.Results:There was no significant difference in positive and negative symptoms scale(PANSS)scores among the three groups at 8 weeks after treatment(P>0.05),8 weeks after treatment,the scores of PANSS in the three groups were lower than those before treatment(P<0.05),but The levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C)in olanzapine group and risperidone group at 8 weeks after treatment were higher than those in aripiprazole group,and those in olanzapine group were higher than those in risperidone group(P<0.05).The high density lipoprotein(HDL-C)in olanzapine group and risperidone group at 8 weeks after treatment was lower than that in aripiprazole group,and that in olanzapine group was lower than that in risperidone group(P<0.05).There was no significant difference in the incidence rate of adverse reactions among the three groups(P>0.05).8 weeks after treatment,the scores of delayed recall,immediate recall,total recall and recognition number in aripiprazole group were higher than those in risperidone group and olanzapine group(P<0.05).8 weeks after treatment,ALT,AST and TBIL in risperidone group were higher than those before treatment(P<0.05),while ALT,AST and TBIL in risperidone group at 8 weeks after treatment were higher than those in aripiprazole group and olanzapine groups(P<0.05).Conclusion:Risperidone,aripiprazole and olanzapine are used in children and adolescents with schizophrenia,they can obtain considerable therapeutic effect.Among them,risperidone has a greater impact on liver function,olanzapine has a greater impact on blood lipid.Aripiprazole has less effect on blood lipid and liver function,and the effect of improving cognitive function is better than risperidone and olanzapine.