奥氮平与齐拉西酮分别联合氟西汀治疗女性神经性厌食症

Effects of olanzapine and ziprasidone combined with fluoxetine in the treatment of female anorexia nervosa on total score,BMI and sex hormone levels of EAT-26

目的:观察奥氮平或齐拉西酮联合氟西汀治疗女性神经性厌食症(AN)对进食障碍检测问卷(EAT-26)总评分、体质量指数(BMI)及性激素水平的影响。方法:前瞻性地选取2018年3月至2021年3月某院收治的102例AN患者作为研究对象。所有患者以简单数字随机表法随机分成奥氮平组(奥氮平联合氟西汀,51例)和齐拉西酮组(齐拉西酮联合氟西汀,51例)。比较两组EAT-26总评分、BMI及性激素[促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、催乳素(PRL)]水平。结果:两组治疗后EAT-26评分均显著低于治疗前(t=9.784,13.103;P<0.05)。两组治疗前、治疗后EAT-26评分及治疗前后EAT-26评分差值比较差异无统计学意义(P>0.05)。奥氮平组治疗4周、治疗8周BMI均高于齐拉西酮组(P<0.05)。两组患者治疗后LH、FSH及E2均显著高于治疗前(t=-8.245,-7.043,-4.541,-17.190,-6.426,-5.324;P<0.05),奥氮平组治疗后PRL水平显著高于治疗前(t=-14.530,P<0.05)。治疗后奥氮平组PRL水平显著高于齐拉西酮组(t=-12.500,P<0.05)。两组安全性事件发生率比较差异无统计学意义(P>0.05)。结论:奥氮平或齐拉西酮联合氟西汀均能降低EAT-26总评分,但奥氮平可导致BMI、PRL异常增加。

Objective:To observe the effects of olanzapine or ziprasidone combined with fluoxetine on total score,BMI and sex hormone level of EAT-26 in female patients treated with AN.Methods:A total of 102 patients with AN admitted to our hospital from March 2018 to March 2021 were prospectively selected as the study subjects.All patients were randomly divided into olanzapine group(olanzapine combined with fluoxetine,51 cases)and ziprasidone group(ziprasidone combined with fluoxetine,51 cases)by simple digital random table method.Total EAT-26 score,BMI and sex hormone levels(LH,FSH,E2,PRL)were compared between the two groups.Results:The EAT-26 score after treatment in both groups was significantly lower than that before treatment(t=9.784,13.103;P<0.05).There was no significant difference in EAT-26 scores before and after treatment between the two groups(P>0.05).BMI in olanzapine group was higher than that in ziprasidone group at 4 and 8 weeks of treatment(P<0.05).After treatment,LH,FSH and E2 in 2 groups were significantly higher than before treatment(t=-8.245,-7.043,-4.541,-17.190,-6.426,-5.324;P<0.05),and PRL level in olanzapine group was significantly higher than before treatment(t=-14.530,P<0.05).PRL level in olanzapine group was significantly higher than that in ziprasidone group after treatment(t=-12.500,P<0.05).There was no significant difference in the incidence of safety events between the two groups(P>0.05).Conclusion:Olanzapine or ziprasidone combined with fluoxetine can decrease the total EAT-26 score,but Olanzapine can cause abnormal increase of BMI and PRL.