喹硫平治疗奥氮平疗效不佳的谵妄患者临床疗效观察  

Efficacy of quetiapine on patients with acute delirium resistant to olanzapine

作　　者：虞洪[1] 章浩明 张颖然[1] 夏时炎 

机构地区：[1]浙江萧山医院精神卫生中心,311200 [2]富阳市第三人民医院

出　　处：《浙江医学》2015年第14期1224-1226,1230,共4页Zhejiang Medical Journal

摘　　要：目的观察喹硫平对伴发急性谵妄经奥氮平治疗无效患者的临床疗效。方法将37例确诊为急性谵妄、经奥氮平治疗无效的住院患者简单随机化分为研究组19例和对照组18例;研究组换用喹硫平,对照组继续使用奥氮平治疗,7d后比较两组的脱落率和不良反应发生率,并分析研究组患者在入组当天、第3天、第7天的简明精神病量表(BPRS)、谵妄评定量表(CAM-CR)、临床总体印象量表(CGI)和药物不良反应量表(TESS)的评分。结果研究组在为期1周的观察期间只有2例需合用或换用其他抗精神病药,脱落率10.5%;而对照组有11例脱落,脱落率达61.1%,两组比较差异有统计学意义(P<0.01);研究组不良反应发生率与对照组比较差异无统计学意义(P>0.05)。研究组治疗7d后显效率为73.7%;BPRS、CAM-CR和CGI量表评分均下降,差异有统计学意义(P<0.01)。结论对奥氮平治疗无效的谵妄患者换用喹硫平治疗后仍有效,起效快且不良反应小,可以作为一线药物用于谵妄的治疗。Objective To evaluate the clinical efficacy of quetiapine on acute delirium in patients resistant to olanzap- ine therapy. Methods Thirty seven patients with acute delirium resistant to olanzapine therapy were randomly assigned in two groups： 19 patients switched to quetiapine treatment （study group） and 18 patients in control continued with olanzapine treatment for up to one week. The difference of the dropout rates between two groups was utilized to judge the efficacy of the two treat- ments. The scores of Brief Psychiatric Rating Scale （BPRS）, Delirium Rating Scale （CAM-CR）, Clinical Global Impression Scale （CGI） and drug side effects scale（TESS） were assessed at d 0, 3 and 7. Results Only two patients （10.5%） required to combine with or switch to other antipsychic drugs in study group, while the dropout rate in control group was 61.1%（11/18）（P〈0.01）. The efficacy of the quetiapine treatment for one week was 73.7% in study group. BPRS, CAM-CR and CGt scales all significantly decreased in study group（P〈0.01 compared to the control group）. The overall adverse reaction in two groups was similar（P 〉0.05）. Conclusion Quetiapine treatment is effective in the control of acute delirium in patients resistant to olanzapine.

关 键 词：谵妄 喹硫平 奥氮平 

分 类 号：R749[医药卫生—神经病学与精神病学]