利培酮、阿立哌唑对首发精神分裂症患者心肌酶和心电图的影响比较

Comparison of effects of risperidone and aripiprazole on myocardial enzymes and electrocardiogram in patients with first-episode schizophrenia

目的 比较利培酮、阿立哌唑对首发精神分裂症患者心肌酶和心电图的影响。方法 80例首发精神分裂症患者,随机分为对照组及实验组,各40例。对照组接受利培酮治疗,实验组接受阿立哌唑治疗。比较两组治疗效果、心电图异常发生情况及治疗前后糖脂代谢指标[空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、心肌酶相关指标(乳酸脱氢酶、肌酸激酶和肌酸激酶同工酶)。结果 实验组治疗总有效率92.50%显著高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗后,两组FPG、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05);对照组治疗后TG、TC水平高于治疗前,且高于实验组,差异具有统计学意义(P<0.05);对照组治疗后FPG、LDL-C、HDL-C水平与治疗前比较,差异无统计学意义(P>0.05);实验组治疗后FPG、TG、LDL-C、HDL-C、TC水平与治疗前比较,差异无统计学意义(P>0.05)。治疗后,实验组乳酸脱氢酶(713.58±10.63)IU/L、肌酸激酶(815.27±36.39)IU/L和肌酸激酶同工酶(294.57±20.11)IU/L均显著高于对照组的(654.65±6.47)、(720.27±33.56)、(253.54±20.14)IU/L,差异有统计学意义(P<0.05)。实验组心电图异常发生率12.50%显著低于对照组的37.50%,差异有统计学意义(P<0.05)。结论 阿立哌唑治疗对首发精神分裂症疗效更加显著,安全性好,且对血糖、血脂水平影响较小,应多加推广应用,有助于提高治疗效果,减少心电图异常的发生。

Objective To compare the effects of risperidone and aripiprazole on myocardial enzymes and electrocardiogram in patients with first-episode schizophrenia.Methods A total of 80 patients with first-episode schizophrenia were randomly divided into the control group and the experimental group,with 40 cases in each group.The control group was treated with risperidone,and the experimental group was treated with aripiprazole.Both groups were compared in terms of therapeutic effect,occurrence of abnormal electrocardiogram,glucose and lipid metabolism indexes[fasting plasma glucose(FPG),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)]and myocardial enzym-related indexes(lactate dehydrogenase,creatine kinase and creatine kinase isoenzyme)before and after treatment.Results The total effective rate of 92.50%in the experimental group was significantly higher than that of 75.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in the levels of FPG,LDL-C and HDL-C between the two groups(P>0.05).After treatment,the levels of TG and TC in the control group were higher than those before treatment in this group and those in the experimental group,and the difference was statistically significant(P<0.05).The levels of FPG,LDL-C and HDL-C in the control group after treatment were not significantly different from those before treatment(P>0.05).The levels of FPG,TG,LDL-C,HDL-C and TC in the experimental group after treatment were not significantly different from those before treatment(P>0.05).After treatment,the experimental group had lactate dehydrogenase of(713.58±10.63)IU/L,creatine kinase of(815.27±36.39)IU/L and creatine kinase isoenzyme of(294.57±20.11)IU/L,which were significantly higher than those of(654.65±6.47),(720.27±33.56)and(253.54±20.14)IU/L in the control group,and the differences were statistically significant(P<0.05).The incidence of electrocardiogram abnormalities in the experimental group was 12.50%,which was significantly lower than that of 37.50%in the control group,and the difference was statistically significant(P<0.05).Conclusion Aripiprazole is more effective and safe in the treatment of first-episode schizophrenia,and has little effect on blood glucose and blood lipid levels.It should be promoted and applied more,which is helpful to improve the therapeutic effect and reduce the occurrence of electrocardiogram abnormalities.