奎硫平与利培酮治疗高龄老年人脑血管病所致精神障碍的疗效及安全性对照研究  

A comparative study of quetinpine and risperidone in treatment of mental disorders due to vascular disease in the advanced elderly

作　　者：成敬[1] 阳胜秋[1] 陈耀银[1] 李承晏[2] 王高华[1] 王晓萍[1] 陈振华[1] 白雪光[1] 刘忠纯[1] 杨越秀[1] 

机构地区：[1]武汉大学人民医院精神卫生中心,430060 [2]武汉大学人民医院神经科,430060

出　　处：《中华精神科杂志》2009年第3期149-152,共4页Chinese Journal of Psychiatry

摘　　要：目的比较奎硫平与利培酮治疗高龄老年人脑血管病所致精神障碍的疗效及安全性。方法68例年龄≥75岁的脑血管病所致精神障碍的老年患者随机分为2组，分别服用奎硫平[（150±45）mg／a；32例]或利培酮[（1．8±0．8）mg／d；31例]，疗程均为6周。采用阳性和阴性症状量表（PANSS）、临床疗效总评量表（CGI）及治疗中需处理的不良反应量表（TESS）于治疗前和治疗后第1，2，4，6周末分别评定疗效和副反应。结果（1）奎硫平组的有效率为72％，利培酮组为71％，差异无统计学意义（x^2=0．006，P〉0．05）；（2）2组治疗前后PANSS评分的差异均有统计学意义（配对t检验，P〈0．05或〈0．01）；（3）奎硫平组PANSS总分减分率在治疗第1周末高于利培酮组（t=2．46，P〈0．05），治疗第2，4，6周末的差异均无统计学意义（t2w=0．43，t4w=-0．73，t6w=-0．24，P均〉0．05）；（4）2组间CGI评分的差异无统计学意义（Z1w=0．57，Z2w=0．74，z4w=0．68，Z6w=-0．61，P〉0．05）；（5）TESS评定，2组间的不良反应发生率的差异无统计学意义（四格表精确检验法，P〉0．05）。治疗期间利培酮组合用苯二氮革类药者多于奎硫平组，差异有统计学意义（x^2=6．224，P〈0．05）。结论奎硫平和利培酮均对高龄老年人的脑血管病所致精神障碍有效，安全性较好。Objective To compare the efficacy and side effects of quetiapine and risperidone in treatment of mental disorders due to vascular disease in the advanced elderly. Methods A total of 68 elderly with mental disorders due to vascular disease were randomly assigned to receive quetiapine or risperidone for 6 weeks. The Positive and Negative Syndrome Scale （PANSS）, Clinical Global Impression （CGI-SI） and Treatment Emergent Symptom Scale （TESS） were adopted to evaluate the efficacy and side effects at baseline and after 1, 2, 4 and 6 week treatment. Results （ 1 ） After 6 week treatment, the response rate between the quetiapine and the risperidone groups was similar （72% vs. 71% , x^2 =0. 006,P 〉0. 05）. （2） The PANSS scores in beth groups decreased signifieantly （P 〈0. 05 or P 〈0. 01 ）. （3）The decreasing radio of PANSS total score was significant higher in quetiapine group than in risperidone group after 1 week treatment （ t = 2. 46, P 〈 0. 05 ）, whereas no significant differences were found between the two groups from 2 to 6 week treatment （ t2w = 0. 43, t4w = - 0. 73, t6w = - 0. 24, all P 〉 0. 05 ）. （4） The CGI-SI score was not significantly different between groups from 1 week to 6 week treatment. （ Z1w = 0. 57, Z2w = 0. 74, Z4w = 0.68,Z6w =0.61,all P〉0.05）. （5） The TESS showed the rate and severity of side effects did not differ between the two groups （ P 〉 0. 05 ）. The coedications for anxiety was significantly less frequent in quetiapine than risperidone group （ x^2 = 6. 224, P 〈 0. 05 ）. Condusion Quetiapine and risperidone both provide valuable treatment options for the advanced elderly with mental disorders due to vascular disease.

关 键 词：老年人 脑血障碍 精神障碍 利哌立酮 奎硫平 

分 类 号：R686[医药卫生—骨科学]