奥氮平治疗首发精神分裂症1年随访  

One year follow-up study on olanzapine in the treatment of patients with first-episode schizophrenia

作　　者：张红霞[1] 江开达[2] 沈晓玲[2] 唐文忠[2] 杨晓敏[2] 

机构地区：[1]复旦大学附属中山医院心理医学科 [2]上海市精神卫生中心

出　　处：《中国神经精神疾病杂志》2007年第8期459-462,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：上海市精神疾病临床医学中心科研基金资助项目(编号:K001-01)

摘　　要：目的了解奥氮平长期治疗首发精神分裂症的疗效、不良反应等。方法采用自然观察研究方法,结合全病程管理模式对研究对象进行1年随访观察。136例符合国际疾病分类第十次修订本(ICD-10)精神分裂症或分裂样精神障碍研究用诊断标准的首发患者纳入研究,给予可变剂量的奥氮平治疗。采用阳性和阴性症状量表(PANSS)评估疗效,副反应量表(TESS)评估治疗的不良反应。PANSS减分率≥50%为有效。结果治疗第2个月末有效率为50%(65/129),第3、6、8、12个月末的有效率分别为57%(71/125)、63%(70/69)、71%(73/103)、75%(70/93)。101例治疗有效的患者中随访期间有17例复发。1年末43例脱落,脱落率为31.6%。奥氮平的平均持续治疗时间为(9.7±3.8)个月(1～12个月)。不良反应发生率≥10%的有:体重增加、嗜睡、便秘、口干、静坐不能、震颤、活动减退、头晕、视物模糊等。结论奥氮平长期治疗首发精神分裂症有效,也存在体重增加等不良反应。Objective To explore the long-term effectiveness of olanzapine in the treatment of patients with firstepisode schizophrenia, meanwhile to evaluate the adverse events. Methods It was a one-year follow-up study with integrated case management and naturalistic observation. One hundred and thirty-six patients of first-episode schizophrenia were included. Patients met ICD-10 criteria for schizophrenia or schizophreniform disorder and were treated with olanzapine, the dose of which was not fixed. Clinical status was assessed with the Positive and Negative Syndrom Scale （ PANSS ） and the Treatment Emergent Symptom Scale （TESS）. Response was defined as improvement in PANSS total score of I〉50%. Resuits The response rates at the end of 2, 3, 6, 8, 12 months were 50% （65/129）, 57% （71/125）, 63% （70/69）, 71% （73/103） , 75% （70/93） , respectively. There were 101 patients who achieved response, and 17 of whom relapsed. Forty-three patients only completed partial follow-up assessments, so the drop-out rate was 31.6%. The mean time to the discontinuation was （9.7 ±3.8） months （range： 1±12 months）. The adverse events reported in ≥10% of patients were weight gain, somnolence, constipation, dry mouth, akathisia, tremor, sedation, dizziness and blurred vision. Conclusions Olanzapine was effective for patients with first-episode schizophrenia, yet the adverse events such as weight gain must be considered.

关 键 词：奥氮平 精神分裂症 疗效 全病程管理 随访 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.053[医药卫生—临床医学]