奥氮平及阿立哌唑治疗首发精神分裂症患者的疗效及对甲状腺激素的影响

The efficacy of olanzapine and aripiprazole in patients with first-episode schizophrenia and their effects on thyroid hormones

目的比较奥氮平、阿立哌唑治疗首发精神分裂症患者的效果及对甲状腺激素的影响。方法选取2016年1月~2018年9月本院收治的首发精神分裂症患者136例,按随机数表法分为两组,均68例。奥氮平组给予奥氮平片10~20 mg/d治疗,阿立哌唑组给予阿立哌唑片10~30 mg/d治疗,治疗12周。观察两组治疗前后阳性和阴性症状量表(PANSS)评分、甲状腺激素(T4、T3、TSH、FT3、FT4)水平。结果两组治疗总有效率(奥氮平组85.29%、阿立哌唑组82.35%)比较差异无统计学意义(P>0.05)。两组治疗后PANSS评分均较治疗前降低(P<0.05),而组间差异无统计学意义(P>0.05)。相比治疗前,奥氮平组治疗后FT4、T3、T4水平降低(P<0.05),TSH升高(P<0.05);阿立哌唑组FT4降低(P<0.05),而FT3、T3、T4、TSH相比治疗前无统计学差异(P>0.05);治疗后两组FT3水平无统计学差异(P>0.05),奥氮平组FT4、T3、T4低于阿立哌唑组,TSH高于阿立哌唑组,差异有统计学意义(P<0.05)。阿立哌唑组不良反应率(11.76%)低于奥氮平组(16.18%),但差异无统计学意义(χ2=0.551,P>0.05)。结论奥氮平、阿立哌唑对首发精神分裂症治疗效果和安全性均较好,但奥氮平对患者甲状腺激素的影响更显著。

Objective To investigate the effects of olanzapine and aripiprazole in patients with first-episode schizophrenia and their effects on thyroid hormones.Methods A total of 136 patients with first-episode schizophrenia admitted to our hospital from January 2016 to September 2018 were enrolled in the study.According to the random number table method,they were divided into two groups,each group were 68 cases.The olanzapine group was given olanzapine tablets 10~20 mg/d,while the aripiprazole group was given aripiprazole tablets 10~30 mg/d.Treated for 12 weeks.The positive and negative symptom scale(PANSS)scores and thyroid hormones(T4,T3,TSH,FT3,FT4)levels were observed before and after treatment.Results There was no significant difference in the total effective rate between the two groups(85.29%in the olanzapine group and 82.35%in the aripiprazole group)(P>0.05).The PANSS scores of the two groups were lower than those before treatment(P<0.05),but there was no difference between the two groups(P>0.05).Compared with before treatment,the levels of FT4,T3 and T4 were decreased(P<0.05)and TSH was increased(P<0.05)after treatment in olanzapine group;compared with before treatment,the FT4 in the aripiprazole group was decreased(P<0.05),but there was no significant difference in FT3,T3,T4 and TSH(P>0.05)after treatment.There was no significant difference in FT3 levels between the two groups(P>0.05),while FT4,T3 and T4 in the olanzapine group were lower than those in the aripiprazole group,and TSH was higher than the aripiprazole group after treatment(P<0.05).The adverse reaction rate of aripiprazole group(11.76%)was lower than that of olanzapine group(16.18%),but the difference was not statistically significant(χ2=0.551,P>0.05).Conclusion Olanzapine and aripiprazole have good therapeutic effects and safety for first-episode schizophrenia,but olanzapine has a more significant effect on thyroid hormones.