经典与非经典抗精神病药物维持治疗对精神分裂症患者转归的影响  

Effects of typical and atypical antipsychotic maintenance treatment on outcome in patients with schizophrenia

作　　者：朱丞[1] 王奕權[1] 曹阳光[1] 陈致宇[1] 

机构地区：[1]杭州市第七人民医院精神科,310013

出　　处：《浙江医学》2013年第23期2083-2086,共4页Zhejiang Medical Journal

基　　金：杭州市科技局医学重点专科专病项目(20091233Q15)

摘　　要：目的比较经典与非经典抗精神病药物长期维持治疗对精神分裂症患者转归的影响。方法选择255例出院的精神分裂症患者,依据其出院后1个月且病情稳定时服用的治疗药物分为经典抗精神病药物治疗组(经典组)45例和非经典抗精神病药物治疗组(非经典组)210例,进行为期2年的随访观察。分别用阳性及阴性症状量表(PANSS)、生活质量量表(SQOL)、个人和社会功能量表(PSP)和不良反应量表(TESS)评估患者的症状、生活质量、社会功能及药物不良反应。结果与基线期相比,经典组与非经典组患者在随访2年时PANSS评分及SQOL评分均显著下降;但两组间PANSS及SQOL评分差值的差异均无统计学意义。与基线期相比,在随访2年时,经典组患者PSP评分与基线期的差异无统计学意义;而非经典组患者PSP评分较基线期均有显著性提高;且两组之间PSP评分差值的差异有统计学意义。非经典组体重增加的发生率显著高于经典组。结论精神分裂症患者长期服用非经典抗精神病药物维持治疗,疗效与经典抗精神病药物相当,并且药物不良反应更少,能够获得更好的生活质量及社会功能。Objective To compare the effects of typical and atypical antipsychotic maintenance treatment on outcome in patients with schizophrenia. Methods A total of 255 inpatients included from June 2009 to September 2011 were divided into two groups： the typical antipsychotics group（Typical Group） and the atypical antipsychotics group（Atypical Group） according to the drugs they took a month after discharge from hospital and in stable condition. Symptoms, quality of life, social function and adverse reaction of all patients were assessed with the Positive and Negative Symptoms scale （PANSS）, the Self-report quality of life scale （SQOL）, the Personal and Social performance scale （PSP）, and the Treatment Emergent Symptom Scale （TESS） at baseline, half a year, one and two years after, Results At the end of the follow up, the atypical group＇s total PSP scores were significantly higher than typical group; the total PANSS score and the total SQOL score of atypical group were lower than typical group, but there was no statistical significance. Among adverse reactions, only weight gain was significantly higher in atypical group than in typical group. Conclusion The atypical antipsychotics are not only as effective as typical antipsychotics in main- tance therapy of schizophrenic, but also has better quality of life and social function, and less adverse reactions than typical an- tipsychotic.

关 键 词：精神分裂症 抗精神病药 转归 随访 

分 类 号：R749.3[医药卫生—神经病学与精神病学]