帕利哌酮与奋乃静治疗老年期精神分裂症的临床研究

Clinical research of paliperidone and perphenazine in the treatment of aged patients with schizophrenia

目的:探讨帕利哌酮与奋乃静治疗老年期精神分裂症的临床疗效。方法:2012年7月-2014年6月收治老年期精神分裂症患者60例,随机分成帕利哌酮组和奋乃静组,每组30例。帕利哌酮组开始用量3 mg/d,最小剂量3mg/d,最大剂量9 mg/d;奋乃静组开始用量4 mg/d,最小剂量4 mg/d,最大剂量40 mg/d,两组均治疗24周。结果:两组患者治疗前PANSS评分比较差异无统计学意义(P>0.05),治疗1、8、12周后,两组均明显下降,与治疗前比较差异有统计学意义(P<0.05),但是治疗1、2、8周后两组PANSS评分比较,差异无统计学意义(P>0.05),但是在治疗24周后帕利哌酮组PANSS评分明显低于奋乃静组,两组比较有统计学意义(P<0.05)。帕利哌酮组发生并发症共4例,并发症发病率13.3%,其中出现体重增加1例,月经不调1例,发生锥体外系反应2例;奋乃静组发生并发症9例,并发症发生率30.0%,其中出现并发症口干2例,头晕2例,体重增加2例,便秘1例,心电图异常2例,两组比较,差异具有统计学意义(P<0.05)。结论:帕利哌酮治疗老年期精神分裂症安全有效,不良反应少,值得临床推广。

Objective:To discuss the clinical effect of paliperidone and perphenazine in the treatment of aged patients with schizophrenia.Methods:60 patients with aged schizophrenia were selected from July 2012 to June 2014.They were randomly divided into the paliperidone group and the perphenazine group with 30 cases in each.The paliperidone group began dosage was 3 mg/d,the minimum dose was 3 mg/d,the maximum dose was 9 mg/d;the perphenazine group began dosage was 4 mg/d,the minimum dose was 4 mg/d,the maximum dose was 40 mg/d;both groups were treated for 24 weeks.Results:Two groups of patients before treatment the PANSS scores had no statistically significant(P>0.05).Treatment of 1,8,12 weeks,two groups were significantly decreased,and there were statistical significance compared with that before treatment(P<0.05),but the treatment 1,2, 8 weeks after,the two groups PANSS scores showed no statistical significance(P>0.05),but in the 24 weeks of treatment the paliperidone group PANSS score was significantly lower than the perphenazine group(P<0.05).The paliperidone group had a total of 4 cases of complications,and complication rate was 13.3%,body weight increased in 1 case,irregular menstruation in 1 cases, extrapyramidal reaction in 2 cases;the perphenazine group had a total of 9 cases of complications,and complication rate was 30.0%,dry mouth in 2 cases,dizziness in 2 cases,body weight increased in 2 cases,constipation in 1 case,ECG abnormalities in 2 cases;there was statistically significant(P<0.05).Conclusion:Paliperidone treatment of elderly patients with schizophrenia is safe and effective.It is worth promoting.