氯氮平联合碳酸锂对双相情感障碍狂躁症患者临床疗效及心脏副作用的影响

Effects of Clozapine Combined with Lithium Carbonate on Clinical Efficacy and Cardiac Side Effects in Patients with Bipolar Disorder and Mania

目的:探讨双相情感障碍(BD)狂躁症患者采用氯氮平联合碳酸锂治疗对临床疗效及心脏副作用的影响。方法:选取2022年1月—2023年1月新郑天佑中医院精神科收治的86例BD狂躁症患者作为研究对象,以随机数表法分成对照组43例与研究组43例。对照组给予碳酸锂治疗,研究组给予氯氮平联合碳酸锂治疗,比较两组患者临床疗效、症状严重程度[贝克-拉范森躁狂量表(BRMS)、阳性和阴性综合征量表(PANSS)评分]、生活质量[世界卫生组织生活质量量表(WHOQOL-100)评分]及心脏不良反应发生情况。结果:研究组患者治疗总有效率高于对照组,差异有统计学意义(χ^(2)=5.108,P<0.05);治疗后,两组患者BRMS、PANSS评分均有所下降,且研究组低于对照组,差异均有统计学意义(t=6.365、8.406,P<0.05);治疗2个月后,两组患者WHOQOL-100评分有所升高,且研究组高于对照组,差异有统计学意义(t=8.449,P<0.05);研究组患者心脏不良反应发生率为9.30%(4/43),低于对照组的16.28%(7/43),差异无统计学意义(χ^(2)=0.938,P>0.05)。结论:氯氮平联合碳酸锂用于治疗BD狂躁症,能够提高患者的临床疗效,缓解其临床症状,促进其生活质量提升,可避免加重心脏副作用。

Objective:To explore the effect of Clozapine combined with Lithium carbonate on clinical efficacy and cardiac side effects in patients with BD manic disorder.Methods:A total of 86 patients with BD mania who were admitted in the Psychiatry Department,Xinzheng Tianyou Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected,and divided into the study group(43 cases)and the control group(43 cases)by random number table method.The control group was treated with Lithium carbonate,and the study group was treated with Clozapine combined with Lithium carbonate.The clinical efficacy and symptom severity(BRMS,PANSS),quality of life(WHOQOL-100)and adverse cardiac reactions of the two groups were compared.Results:The total effective rate of treatment in the study group was higher,with statistically significant difference(χ^(2)=5.108,P<0.05).After 2 months of treatment,the BRMS and PANSS scores in both groups were decreased,and in comparision of the control group,the study group was lower(t=6.365,8.406;P<0.05).After 2 months of treatment,the WHOQOL-100 scores in both groups were improved,and in comparision of the control group,the study group was higher(t=8.449,P<0.05).In the incidence of adverse cardiac reactions,there was no statistically significant difference between the study group(9.30%)and the control group(16.28%)(χ^(2)=0.938,P>0.05).Conclusion:Clozapine combined with Lithium carbonate in the treatment of BD mania can improve the clinical efficacy,alleviate clinical symptoms,promote quality of life,and avoid aggravating cardiac side effects.