齐拉西酮与奥氮平治疗首发精神分裂症的疗效和安全性比较  

Efficacy and safety of ziprasidone versus Olanzapine in first-episode schizophrenia:a 6-week,multicenter,randomized,flexible-dose study

作　　者：邵平[1] 欧建君[2] 吴仁容[2] 房茂胜[3] 陈红辉[3] 许毅[4] 赵靖平[2] 

机构地区：[1]湖南省脑科医院,长沙410007 [2]中南大学精神卫生研究所 [3]武汉市精神卫生中心 [4]浙江大学医学院附属第一医院

出　　处：《国际精神病学杂志》2013年第2期73-77,共5页Journal Of International Psychiatry

基　　金：高校博士点基金(20090162110012)

摘　　要：目的比较齐拉西酮和奥氮平对首发精神分裂症的疗效和安全性。方法 260名病人被随机分配到两组进行为期6周的药物治疗。使用阳性和阴性症状量表(PANSS)和临床总体印象-疾病严重程度量表(CGI-S)评定药物的主要疗效。使用不良事件记录表的记录与药物相关的不良反应。结果共有245名患者完成研究,齐拉西酮组平均剂量137.5mg/d,奥氮平组19.5mg/d。奥氮平组PANSS评分的改善显著优于齐拉西酮组(P<0.05),而CGI-S评分在两组间的差异无显著性(P>0.05)。两种药物的耐受性均较好,齐拉西酮组有QTc间期延长和锥体外系副反应(EPS),奥氮平组有显著的体重增加(组间比较P<0.05)。结论虽然奥氮平对首发精神分裂症的短期疗效要优于齐拉西酮,但齐拉西酮几乎不会引起体重增加。在临床用药中需综合考虑两种药物的优劣。Objective To compare the efficacy schizophrenia. Methods 260 patients were randomly and safety of Ziprasidone versus Olanzapine in first-episode assigned to treatment for 6 weeks either with ziprasidone or Olanzapine. The primary efficacy measurement was the change of Positive and Negative Syndrome Scale （PANSS） and the Clinical Global Impression-severity scale （CGI-S） scores from baseline to the end of study. The adverse events （AEs） were recorded by the investigator. Results 245 patients completed the trial. The average dose was 137. 5mg/d in the Ziprasidone group and 19. 5mg/d in the Olanzapine group. The Olanzapine group showed sig- nificantly more improvement than the Ziprasidone group on the PANSS tatol score. No significant differences were found between the two groups in CGI-S score. Both agents were well tolerated. Prolongation of QTc and extrapyra-midal symptoms were more significant in Ziprasidone group than in Olanzapine group. Body weight significantly in- creased with Olanzapine but not with Ziprasidone. No serious AEs were observed in this study. Conclusion A1- thought Olanzapine is more effective than Ziprasidone in the short-term treatment of first-episode schizophrenia, zi- prasidone almost does not induce weight gain. Both the advantages and disadvantages of the two agents should be considered in the clinical selection.

关 键 词：齐拉西酮 奥氮平 首发精神分裂症 疗效 安全性 

分 类 号：R749.05[医药卫生—神经病学与精神病学]