奥氮平治疗青春期孤独症患者的疗效和安全性研究  

Efficacy and safety study of olanzapine treatment in autism adolescents

作　　者：柯晓殷 张英[1] 寇聪[1] 齐云柯 卢建平[1] 杨志伟[1] 

机构地区：[1]深圳市康宁医院,深圳市精神卫生中心,深圳市心理健康重点实验室

出　　处：《国际精神病学杂志》2015年第3期9-12,共4页Journal Of International Psychiatry

基　　金：深圳市卫生计生系统科研项目(编号:201402093)

摘　　要：目的探讨奥氮平治疗青春期孤独症患者的疗效及安全性。方法用奥氮平对34例12～18岁符合ICD-10诊断的孤独症患者进行治疗,剂量为5～20mg/日,连续用药并观察8周在治疗开始时、治疗后第4周、8周采用临床疗效总评量表和临床记录对患者进行评定,以评估其病情严重程度及奥氮平的疗效和副作用。结果与治疗开始时比较,用药后第4周、第8周CGI各项指标变化均有显著性意义（P〈0.001）;治疗后第8周,严重程度、疗效总评、疗效、疗效指数与第4周时的相比较,有显著性差异（P〈0.05）,而副反应的变化无显著性意义（P=0.655）;靶症状的改变主要集中在易激惹、攻击行为、自伤自杀行为、活动过度、注意力不集中、精神病性症状及睡眠障碍等症状,对刻板行为也有较好的疗效,但对孤独症的核心症状如言语障碍、社交障碍的疗效相对较差;所有入组患者均未发生严重的药物副作用,主要表现为随治疗时间延长而减轻的镇静作用、可控的食欲体重增加和轻微的锥体外系副作用。结论奥氮平治疗青春期孤独症患者是安全有效的。Objective To explore efficacy and safety of olanzapine treatment in adolescent autism. Methods 34 autism adolescents age from 12 to 18 were treated with olanzapine at 5～20rag daily for 8 weeks. CGI and clini- cal observation were employed to assess the severity, efficacy and side effects at the beginning, 4 weeks and 8 weeks after administration of olanzapine. Results ①Each indices of CGI changed significantly （P〈0. 001 ） at the 4th and 8th weeks comparing with those at the baseline. ②The severity, global improvement, efficacy and efficacy index altered significantly （P〈0. 05） at the 8th week comparing with those at the 4th week while side effect did not （P = 0. 655）. The alterative symptoms lied in the irritability, aggressive behavior, self-injury, suicide, hyperac- tivity, inattention, psychotic symptoms and abnormal sleep, as well as stereotyped behavior. However, the core symptoms of autism, such as speech disorder, social disorder, relieved poorly. Severe side effects did not happened among all the participants. The major adverse events were attenuated sedation along with therapy time, reversible elevated appetite and weight gain, and mild extrapyramidal side effects. Conclusion Olanzapine is effective and safe in the treatment of adolescent autism patients.

关 键 词：孤独症 奥氮平 疗效 安全性 

分 类 号：R749.05[医药卫生—神经病学与精神病学]