头孢曲松钠联合阿立哌唑治疗神经梅毒伴发精神症状的临床观察  

Clinical Observation of Ceftriaxone Combined with Aripiprazole in the Treatment of Neurosyphilis with Psychiatric Symptoms

作　　者：靳西龙[1] 许秋霞[1] 郭玮刚[1] 戴雄凯[1] 

机构地区：[1]湖州市第三人民医院精神科,浙江湖州313000

出　　处：《中国药房》2015年第15期2087-2089,共3页China Pharmacy

摘　　要：目的：观察头孢曲松钠联合阿立哌唑治疗神经梅毒伴发精神症状的临床疗效及安全性。方法：选择神经梅毒伴发精神症状的患者52例,给予头孢曲松钠2 g,静脉滴注,每日1次,连续2周＋阿立哌唑起始剂量4~6 mg,口服,每日1次,根据病情调整剂量,每日最大剂量不超过30 mg,连续6周。记录患者阳性和阴性综合征量表（PANSS）评分、临床疗效总评量表病情严重程度（CGI-SI）评分及精神症状临床疗效和不良反应发生情况,随访快速血浆反应素试验（RPR）转阴情况和复发情况。结果：所有患者停药3个月后RPR滴度均下降75%左右,第3年后的转阴率达96.15%,且复发率只有4.76%;第1、3、6周末的PANSS阳性症状、一般精神病理症状及总评分持续降低,与治疗前比较差异均有统计学意义（P〈0.05）,而阴性症状评分与治疗前比较差异无统计学意义（P〉0.05）;精神症状治疗总有效率为65.38%;第1、3、6周末的CGI-SI评分持续降低,与治疗前比较差异均有统计学意义（P〈0.05）;不良反应发生率为15.4%,且均为轻度。结论：头孢曲松钠联合阿立哌唑治疗神经梅毒伴发精神症状的疗效与安全性均较好,且对精神症状有明显的改善。OBJECTIVE：To observe the clinical efficacy and safety of ceftriaxone combined with aripiprazole in the treatment of neurosyphilis with psychiatric symptoms.METHODS：Totally 52 neurosyphilis patients with psychiatric symptoms were given ceftriaxone 2 g,iv,once a day,for 2 weeks;and orally given aripiprazole with the initial dose of 4-6 mg,once a day,and then the dose was adjusted based on the patients＇ conditions,no more than 30 mg a day,for 6 weeks.The clinic data was recorded,including the scores of positive and negative syndrome scale（PANSS）and clinical global impression severity（CGI-SI）,the clinical efficacy of psychiatric symptoms and ADR.The rapid plasma reagin（RPR）negative and recurrence were followed up.RESULTS：The RPR titer of all patients was decreased about 75% after 3 months withdrawal,the negative rate was reached 96.15% after 3years and the recurrence rate was 4.76%.The PANSS positive symptoms and general psychopathological symptoms were continuously decreased in the weekends of 1,3 and 6 weeks,with significant differences（P〈0.05）.There was no significant difference in the negative symptoms scores（P〉0.05）;the total effective rate of psychiatric symptoms treatment was 65.38%;the CGI-SI scores were continuously decreased in the weekends of 1,3 and 6 weeks,with significant differences（P〈0.05）.The ADR was15.4% and they were mild.CONCLUSIONS：Ceftriaxone combined with aripiprazole has better clinical efficacy and safety in the treatment of neurosyphilis with psychiatric symptoms.It can obviously improve the psychological symptoms.

关 键 词：头孢曲松钠 阿立哌唑 神经梅毒 精神症状 疗效 安全性 

分 类 号：R759.13[医药卫生—皮肤病学与性病学]