奥氮平辅助治疗卒中后眩晕疗效的初步观察  

Efficacy of olanzapine in the adjuvant treatment of post-stroke vertigo:a preliminary observation

作　　者：李盛鋆[1] 郭秀海[1] 万敏[1] 武剑[1] 贾建平[1] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国脑血管病杂志》2010年第11期565-569,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：北京市科技新星计划项日(2005B53)

摘　　要：目的探讨奥氮平对卒中后眩晕的辅助治疗作用。方法连续纳入2009年12月—2010年4月入住首都医科大学宣武医院卒中单元的伴有严重眩晕症状的缺血性卒中患者共20例。使用随机数据表将入组患者随机分为两组,即联合用药组12例,单用药组8例,两组治疗前基线情况差异无统计学意义。其中联合用药组患者服用倍他司汀6 mg/次,3次/d,附加奥氮平2.5 mg/次,1次/每晚。单用药组单纯服用倍他司汀6 mg/次,3 次/d。各组均观察10 d。采用欧洲眩晕评价量表(EEV)作为疗效的评价指标,同时记录患者的体质量、血糖、血脂及肝功能变化情况等。结果①治疗后第5、10天EEV评分较第1天EEV评分降低的相对数,联合用药组分别为0.41±0.25和0.63±0.31,单用药组为0.17±0.16和0.28±0.23;两组比较差异有统计学意义(P=0.027,P=0.016)。②观察治疗后第10天,两组间EEV各指标的差异,联合用药组相比单用药组在活动耐受性与不平衡性的亚项中得到更好的恢复(P=0.069,P=0.031)。③联合用药组治疗前后的体质量、血糖、血脂及肝功能差异无统计学意义(P>0.05)。在观察治疗期间,联合用药组有1例患者在治疗开始后,因血糖升高提前退出治疗观察。该患者血糖的增高,可能与奥氮平的不良反应有关。结论奥氮平对卒中后眩晕的小样本治疗有显著疗效,尤其在患者活动能力的恢复方面。但还应密切关注其不良反应。其治疗作用尚需大样本的研究加以证实。Objective To investigate the therapeutic effect of olanzapine on patients with post-stroke vertigo. Methods A total of 20 conseeutive patients with ischemie stroke accompanied with severe vertigo were admitted to the stroke unit of Xuanwu Hospital, Capital Medical University from December 2009 to April 2010. They were randomly divided into a combined treatment group （ n = 12 ） and a single treatment group （n = 8）. There was no significant difference of baseline conditions of patients between the two groups befere treatment. The patients in the combined treatment group took betahistine 6 mg three times a day and olanza- pine 2.5 mg once every evening. The patients in the single treatment group took betahistine 6 mg three times a day. Both groups were observed for 10 days. The European Evaluation of Vertigo （EEV） scale was used as the efficacy evaluation index for patients with vertigo. Meantime, the changes of body weight, blood glueose, blood lipid, and liver function of the patients were documented. Results （1）The decreased relative num- bers of the EEV scores at day 5 and 10 in the combined treatment group were 0.41 ± 0. 25 and 0.63 ± 0. 31 compared to those at day 1 in the single treatment group were 0. 17 ±0. 16 and 0. 28 ±0. 23. The differences were significant between the two groups （P =0. 027, P =0. 016）. （2）The differences of the EEV scores of all indexes at day 10 after the treatment between the two groups were observed. Compared to the combined treatment group, the sub-items of the activity tolerance and imbalance in the single treatment group had better recovery （P =0.069, P = 0. 031 ）. （3）There were no significant differences in the body mass index, blood glucose, blood lipid and liver function before and after treatment in the combined treatment group （P 〉 0. 05）. One patient was withdrawn from the observation and treatment early in the combined treatment group during the observation and treatment periods because of the increased blood glucose after starting

关 键 词：卒中 眩晕 治疗结果 奥氮平 

分 类 号：R743.3[医药卫生—神经病学与精神病学]