阿立哌唑联合经颅磁刺激对精神分裂症患者氧化应激及代谢综合征的影响

Effects of Aripiprazole Combined with Transcranial Magnetic Stimulation on Oxidative Stress and Metabolic Syndrome in Patients with Schizophrenia

目的探讨阿立哌唑联合经颅磁刺激对精神分裂症的临床疗效,并分析对患者氧化应激水平及代谢综合征发生率的影响。方法选取2020年10月—2022年10月西安康宁精神病医院收治的90例精神分裂症患者作为研究对象,应用随机数表法将患者分为A、B、C三组,每组30例。A组采取常规奥氯平治疗,B组采取阿立哌唑治疗,C组采取阿立哌唑联合经颅磁刺激治疗,对比三组患者阴性与阳性症状量表(PANSS)评分、氧化应激反应以及糖脂代谢水平与代谢综合征发生率。结果治疗前,A、B、C三组患者阳性症状、阴性症状PANSS评分经比较,差异无统计学意义(P>0.05);治疗后,三组患者阳性症状、阴性症状PANSS评分均降低,C组低于A组和B组,差异有统计学意义(P<0.05),但治疗后A、B两组阳性症状、阴性症状PANSS评分比较,差异无统计学意义(P>0.05)。治疗前,A、B、C三组患者过氧化氢酶(CAT)、总超氧化物歧化酶(T-SOD)、谷胱甘肽过氧化物酶(GSH-Px)相关氧化应激指标水平比较,差异无统计学意义(P>0.05);治疗后,三组患者CAT水平均降低,C组低于A组和B组,T-SOD、GSH-Px水平均升高,C组高于A组和B组,差异有统计学意义(P<0.05),但治疗后A、B两组CAT、T-SOD、GSH-Px水平比较,差异无统计学意义(P>0.05)。治疗前,A、B、C三组患者餐后2 h血糖、空腹血糖、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)比较,差异无统计学意义(P>0.05);治疗后,B组、C组餐后2 h血糖、空腹血糖、LDL均降低,且明显低于A组,差异有统计学意义(P<0.05)。B组、C组代谢综合征发生率明显低于A组,差异有统计学意义(P<0.05);但B组与C组代谢综合征发生率比较,差异无统计学意义(P>0.05)。结论对精神分裂症患者采取阿立哌唑联合经颅磁刺激治疗,能够提升对精神分裂症的治疗效果,降低患者氧化应激反应,而且与常规奥氯平治疗相比能够促进糖脂代谢,降低代谢综合征发生率。

Objective To investigate the clinical effi cacy of aripiprazole in combination with transcranial magnetic stimulation(TMS)in the treatment of schizophrenia and the infl uence on the level of oxidative stress in patients and the incidence of metabolic syndrome.Methods 90 schizophrenic patients admitted to Xi'an Kangning Psychiatric Hospital from October 2020 to October 2022 were selected as research subjects.The patients were divided into three groups,A,B and C,each with 30 patients using a random number table.Group A was treated with conventional olpin,group B with aripiprazole and group C with aripiprazole combined with transcranial magnetic stimulation.PANSS score,oxidative stress response,glucose and lipid metabolism and the incidence of metabolic syndrome were compared between the three groups.Results There was no significant difference in PANSS scores of positive and negative symptoms between groups A,B and C prior to treatment(P>0.05).After treatment,PANSS levels of positive and negative symptoms were lower in group C than in group A and group B(P<0.05),but there was no signifi cant diff erence between group A and group B after treatment(P>0.05).There was no signifi cant diff erence in the concentrations of catalase(CAT),superoxide dismutase(T-SOD)and glutathione peroxidase(GSH-Px)related to oxidative stress in patients in groups B and C prior to treatment(P>0.05).After treatment,CAT levels decreased in the patients in the three groups.The values of T-SOD and GSH Px in Group C were lower than those in Group A and Group B,and the values of T-SOD and GSH-Px in Group C were higher than those in Group A and Group B(P<0.05).However,there was no signifi cant diff erence in GSH-Px levels after treatment(P>0.05).There was no signifi cant diff erence between blood sugar,fasting blood sugar,high-density lipoprotein(HDL)and low-density lipoprotein(LDL)in the three preand post-treatment groups(P>0.05).After treatment,blood sugar,fasting blood sugar and LDL decreased in both groups and were signifi cantly lower than in group A(P<0.05).The incidence of metabolic syndrome in group B and C was signifi cantly lower than in group A,but there was no signifi cant diff erence between group B and group C(P>0.05).Conclusion Treatment of aripiprazole combined with transcranial magnetic stimulation for patients with schizophrenia may improve the therapeutic eff ect of schizophrenia,reduce patients'oxidative stress response and promote glucose and lipid metabolism and reduce the incidence of metabolic syndrome compared to conventional treatment of olpin.