基于PANSS评分、血清细胞因子水平评价齐拉西酮在难治性精神分裂症患者治疗中的效果

Evaluation of the Effect of Ziprasidone in the Treatment of Patients with Refractory Schizophrenia Based on PANSS Score and Serum Cytokine Levels

目的:探讨齐拉西酮在难治性精神分裂症患者治疗中的效果及对患者阳性和阴性精神症状评定量表(PANSS)评分、血清细胞因子水平的影响。方法:选取2019年1月-2022年1月赣州市第三人民医院收治的82例难治性精神分裂症患者作为研究对象,使用随机数字表法将其分为观察组(n=41)和对照组(n=41)。对照组实施奥氮平治疗,基于对照组,观察组实施齐拉西酮治疗。两组患者均连续治疗6周。比较两组患者治疗后的临床效果,治疗前后的PANSS评分、血清脑源性神经生长因子(BDNF)、神经生长因子(NGF)、5-羟色胺(5-HT)、胶质纤维酸性蛋白(GFAP)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平及治疗期间的不良反应发生情况。结果:治疗后,观察组临床总有效率高于对照组(P<0.05);两组阳性症状、阴性症状、一般精神病理症状及总评分、血清GFAP、IL-2、IL-6、TNF-α、IL-17水平与治疗前比均降低,其中观察组均低于对照组(P<0.05);两组血清BDNF、NGF、5-HT水平与治疗前比均升高,其中观察组均高于对照组(P<0.05)。治疗期间,观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论:应用齐拉西酮治疗难治性精神分裂症患者可有效改善精神症状,缓解神经元应激反应,降低神经元损伤,减轻炎症反应,疗效显著且安全性高。

Objective:To investigate the effect of Ziprasidone in the treatment of patients with refractory schizophrenia and its effect on the scores of the positive and negative syndrome scale(PANSS)and serum cytokine levels in patients with schizophrenia.Method:A total of 82 patients with refractory schizophrenia admitted to Third People's Hospital of Ganzhou from January 2019 to January 2022 were selected as the research objects and divided into the observation group(n=41)and the control group(n=41)by random number table method.The control group was treated with Olanzapine,and the observation group was treated with Ziprasidone based on the control group.Both groups were treated for 6 weeks.The clinical efficacy after treatment was compared between the two groups.PANSS score,serum levels of brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),glial fibrillary acidic protein(GFAP),interleukin-2(IL-2),interleukin-6(IL-6),interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)before and after treatment and the occurrence of adverse reactions during treatment were compared.Result:After treatment,the total clinical effective rate of patients in the observation group was higher than that in the control group(P<0.05);positive symptoms,negative symptoms,general psychopathological symptoms and total score,the levels of serum GFAP,IL-2,IL-6,TNF-α,IL-17 in the observation group were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05);the levels of serum BDNF,NGF and 5-HT in the two groups after treatment were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).During the treatment,the total incidence of adverse reactions in the observation group was lower than that in the control group,with a statistically significant difference(P<0.05).Conclusion:The application of Ziprasidone in the treatment of refractory schizophrenia can effectively improve the psychiatric symptoms,relieve neuronal stress response,reduce neuronal damage,reduce inflammation,with significant efficacy and high safety.