盐酸丁咯地尔对不同亚型精神分裂症局部脑血流的影响  

Effect of buflomedil hydrochlorde on regional cerebral blood flow in different subtypes of schizophrenia

作　　者：钟智勇[1] 黄泽萍[2] 韩洪瀛[1] 张晋碚[1] 

机构地区：[1]中山大学附属第三医院精神心理科,广州510630 [2]中山大学附属第三医院超声科,广州510630

出　　处：《中华神经医学杂志》2013年第8期827-832,共6页Chinese Journal of Neuromedicine

基　　金：广东省科技计划项目（20108080701040）

摘　　要：目的 探讨脑血管扩张药盐酸丁咯地尔对不同亚型精神分裂症局部脑血流的影响.方法 选择中山大学附属第三医院精神心理科自2007年2月至2009年2月收治的符合《中国精神障碍分类与诊断标准》第3版中精神分裂症诊断标准患者共286例,分型后分别在各型中按照随机数字表法分为治疗组（采用抗精神病药加盐酸丁咯地尔治疗）和安慰组（采用抗精神病药加安慰剂生理盐水）,其中Ⅰ型86例（治疗组46例,安慰组40例）、Ⅱ型63例（治疗组34例,安慰组29例）、Ⅲ型137例（治疗组72例,安慰治疗组65例）.在治疗第1天和治疗第4周末采用经颅多普勒（TCD）测量不同亚型中2组患者双侧大脑前动脉、大脑中动脉、大脑后动脉、椎动脉和基底动脉的血流量. 结果 （1）Ⅰ型精神分裂症：2组治疗前后及2组之间各项TCD检测结果比较差异均无统计学意义（P＞0.05）.（2）Ⅱ型精神分裂症：在治疗第1天时,2组大脑各动脉血流量比较差异均无统计学意义（P＞0.05）.在第4周末时,治疗组双侧大脑前动脉、大脑中动脉、大脑后动脉血流量明显高于安慰组,差异有统计学意义（P＜0.05）；同时治疗组双侧大脑前动脉、大脑中动脉、大脑后动脉血流量明显高于治疗第1天时,差异有统计学意义（P＜0.05）,而安慰组大脑各动脉血流量与治疗第1天比较差异均无统计学意义（P＞0.05）.（3）Ⅲ型精神分裂症：在治疗第1天时,2组大脑各动脉血流量比较差异均无统计学意义（P＞0.05）.在第4周末时,治疗组左侧大脑前动脉、左侧大脑中动脉和右侧大脑中动脉脑血流量明显高于安慰治疗组,差异有统计学意义（P＜0.05）；同时治疗组双侧大脑前动脉、大脑中动脉血流量明显高于治疗第1天时,差异有统计学意义（P＜0.05）,而安慰组大脑各动脉血流量与治疗第1天比较差异均无统计学意义（P＞0.05）. 结论 Objective To investigate the effect ofbuflomedil hydrochlorde on regional cerebral blood flow in different subtypes of schizophrenia.Methods Two hundred and eighty-six patient met the diagnostic criteria of CCMD-3 for schizophrenia,admitted to our hospital from February 2007 to February 2009,were chosen in our study; patients of type Ⅰ （n=86）,type Ⅱ （n=63） and type Ⅲ （n=137）were randomly divided into treatment group of type Ⅰ （n=46）,placebo treatment group of type Ⅰ （n=40）,treatment group of type Ⅱ （n=34）,placebo treatment group of type Ⅱ （n=29）,treatment group of type Ⅲ（n=72） and placebo treatment group of type Ⅲ （n=65）.Patients from the treatment groups were treated with antipsychotics with buflomedil hydrochloride and those from placebo treatment groups were given antipsychotics with saline for 4 weeks.On the 1st day and at the end of the 4th week of treatment,cerebral blood flows of bilateral anterior cerebral artery,middle cerebral artery,posterior cerebral artery,vertebral artery and basilar arterywere were measured by transcranial Doppler （TCD）.Results No statistically significant difference of cerebral blood flow was noted between the two groups of type Ⅰ before/after treatment,neither between before and after treatment in one of the groups （P〉0.05）.For type Ⅱ schizophrenia,no statistically significant difference of cerebral blood flow was noted between the two groups on the 1st day of treatment （P〉0.05）; however,at the end of 4th week of treatment,cerebral blood flow in the bilateral anterior cerebral artery,middle cerebral artery,posterior cerebral artery blood of the treatment group were significant greater than that in the placebo treatment group （P〈0.05）; the cerebral blood flow in the bilateral anterior cerebral artery,middle cerebral artery,posterior cerebral artery blood of the treatment group at the end of 4th week of treatment was significantly higher than that on the 1 st day of treatment （P〈0.05）,while no sig

关 键 词：精神分裂症 盐酸丁咯地尔 经颅多普勒 脑动脉血流 

分 类 号：R749.3[医药卫生—神经病学与精神病学]