阿立哌唑与奥氮平治疗首发精神分裂症的疗效及对催乳素水平的影响

Analysis of the efficacy of aripiprazole and olanzapine in the acute phase of first-episode schizophreniaand their impact on prolactin

目的 探讨首发精神分裂症急性期患者分别口服阿立哌唑和奥氮平的治疗效果及两种药物对患者催乳素水平的影响.方法 选择2020年11月~2021年12月期间在本院治疗的首发精神分裂症急性期患者180例,按照随机数字表法,分为阿立哌唑组(90例)和奥氮平组(90例),分别予口服阿立哌唑及奥氮平治疗,疗程均为8周.对两组患者治疗前后的阳性与阴性症状量表(PANSS)评分和催乳素水平分析,同时比较两组药物的疗效和不良反应情况.结果 两组患者治疗前的PANSS总评分及各因子(阳性症状、阴性症状、一般精神病理症状)评分、体质量指数(BMI)以及催乳素水平均无差异(P>0.05).相比治疗前,两组患者治疗后的PANSS总分及各因子评分均显著下降(P<0.05),但治疗后的两组间PANSS总分以及各因子评分无差异(P>0.05).治疗后奥氮平组的BMI以及催乳素水平相比治疗前均明显提升(P<0.05),而阿立哌唑组治疗后的BMI以及催乳素水平相比治疗前无明显差异(P>0.05).且治疗后阿立哌唑组的BMI以及催乳素水平显著低于奥氮平组(P<0.05).治疗后两组患者的临床总有效率(阿立哌唑86.67%vs奥氮平83.33%)和不良反应率(阿立哌唑20.00%vs奥氮平25.56%)比较均无差异(P>0.05).结论 首发精神分裂症急性期患者口服阿立哌唑或奥氮平的疗效相当,不良反应无差异,但奥氮平组显著提升患者体质量和血催乳素水平.

Objective To investigate the therapeutic effects of aripiprazole and olanzapine respectively and the effects of the two drugs on prolactin levels in patients with acute stage of first episode schizophrenia.Method A total of 180 patients with first-episode acute schizophrenia who were treated in the psychiatric department of our hospital from November 2020 to December 2021 were selected and divided into aripiprazole group(ninety cases)and olanzapine group(ninety cases)according to random number table method.They were given oral aripiprazole treatment and olan-zapine treatment,respectively.The course of treatment was 8 weeks.The positive and negative symptom scale(PANSS table)scores and prolactin levels before and after treatment were investigated and analyzed,and the therapeutic ef-ficacy and adverse reactions of the two groups were compared.Results There were no differences in the total score of PANSS,the score of each factor(positive symptom,negative symptom,general psychopathological symptom),BMI and prolactin level between two groups before treatment(P>0.05).Compared with before treatment,the total score of PANSS and each factor score of the two groups were significantly decreased after treatment(P<0.05),but there was no difference between the two groups after treatment(P>0.05).After treatment,BMI and prolactin levels in Olanzapine group were significantly increased compared with before treatment(P<0.05),while BMI and prolactin levels in aripip-razole group were not significantly different compared with before treatment(P>0.05).After treatment,BMI and prolactin levels in aripiprazole group were significantly lower than those in olanzapine group(P<0.05).The total clinical response rate after treatment(aripiprazole:86.67%vs.Olanzapine:83.33%)and adverse reaction rate(aripiprazole:20.00%vs.Olanzapine:25.56%)showed no difference(P>0.05).Conclusion Oral aripiprazole or olanzapine has the same therapeutic effect in acute stage of first episode schizophrenia,and there is no difference in adverse reactions.However,olanzapine treatment significantly improves body mass and blood prolactin levels.