阿立哌唑治疗精神分裂症后抑郁的临床疗效及患者生活质量分析  

Clinical efficacy of aripiprazole in schizophrenia patients associated with depressive symptoms and their life quality improvement

作　　者：张峰[1] 王江[1] 

机构地区：[1]北京市大兴区精神病医院精神科,102600

出　　处：《中华神经医学杂志》2013年第5期521-524,共4页Chinese Journal of Neuromedicine

摘　　要：目的分析比较阿立哌唑与利培酮治疗精神分裂症后抑郁的临床疗效和患者生活质量改善状况。方法选择北京市大兴区精神病医院自2011年1月至2012年6月收治的符合精神分裂症后抑郁诊断标准、汉密尔顿抑郁量表（HAMD）17项评分≥18分的88例患者，按随机数字表法分为阿立哌唑组和利培酮组（每组各44例），分别给予阿立哌唑10-30mg／d或利培酮2-6mg／d治疗，疗程共24周。于治疗前及治疗第4、12、24周末对患者采用阳性与阴性症状量表（PANSS）评定精神症状的变化，采用HAMD量表评定抑郁症状的变化．采用临床大体印象量表疾病严重程度评分（CGI-sI）评定总体疗效；于治疗前及第24周末对患者采用世界卫生组织编制的生活质量量表fQOL．100）评定生活质量变化。结果治疗前,阿立哌唑组与利培酮组患者PANSS量表总分、阳性症状评分、阴性症状评分、一般精神病理评分及HAMD量表总分、CGI-SI量表总分、QOL-100量表总分比较差异均无统计学意义（P〉0．05）。治疗后，阿立哌唑组第4周末阳性症状评分、第12、24周末阴性症状评分、第24周末一般精神病理评分及第4、12、24周末HAMD量表总分、第4周末CGI-SI量表总分、第24周末QOL-100量表总分较利培酮组明显好，差异有统计学意义（P〈0．05）。治疗前后，除阿立哌唑组治疗第4周末阴性症状评分、利培酮组治疗第4周末HAMD量表总分外，其余各量表总分及分项评分与治疗前比较差异均有统计学意义（P〈0．05）。结论阿立哌唑能有效减轻精神分裂症后抑郁患者的阴性症状和抑郁症状，提高患者生活质量。Objective To explore the clinical efficacy of aripiprazole in treating patients with schizophrenia complicated with depressive symptoms and its influence in life quality improvement. Methods A total of 88 schizophrenic patients with depressive symptoms who met the ICD-10 diagnostic criteria and had HAMD scores higher than 18, admitted to our hospital from January 2011 to June 2012, were randomly divided into aripiprazole treatment group （n=44） and risperidone treatment group （n=44）; these patients were treated with aripiprazole or isperidone, respectively, for 24 weeks. Psychiatric symptoms were assessed with positive and negative syndrome scale （PANSS）, depressive symptoms were assessed with Hamilton Rating Scale for Depression （HAMD） and clinical efficacy was assessed with Clinical Global Impression-Severity Index （CGI-SI） at the baseline and 4^th, 12^th and 24^th week of treatment. Improvement of life quality was assessed with WHO quality of life （QOL）-100 at the baseline and 24^th week of treatment. Results The total scores of PANSS, positive symptom scale, negative symptom scale, general psychopathology scale, CGI-SI, QOL-100 and HAMD scale showed no significant differences between the two groups at the baseline （P〉0.05）. The scores of positive symptom scale, CGI-SI and HAMD scale four weeks after treatment, the scores of negative symptom scale 12 and 24 weeks after treatment, the scores of QOL-100 and HAMD 24 weeks after treatment showed significant differences between the two groups （P〈0.05）. Except the negative symptom scale scores in thearipiprazole treatment group 4 weeks after treatment and HAMD scale scores 4 weeks after treatment in the risperidone treatment group, all the other scale scores at all different observation time points showed significant difference as compared with those before treatment （P〈0.05）. Conclusion As one of the third generation antipsychotics, aripiprazole can relieve the negative and depressive symptoms in schizophrenia patients posit

关 键 词：阿立哌唑 利培酮 精神分裂症 抑郁 疗效 生活质量 

分 类 号：R749.3[医药卫生—神经病学与精神病学]