齐拉西酮治疗精神分裂症疗效及不良反应的相关因素分析  

Predictive factors for efficacy and adverse reactions of ziprasidone in schizophrenia patients

作　　者：朱虹[1] 贾竑晓[1] 阎爱国 职利花[1] 

机构地区：[1]首都医科大学附属北京安定医院中西医结合研究室北京重大脑疾病研究院精神分裂症研究所精神疾病诊断与治疗北京市重点实验室,北京100088 [2]北京平谷区精神病医院4区,北京101201

出　　处：《首都医科大学学报》2016年第2期164-167,共4页Journal of Capital Medical University

基　　金：国家临床重点专科建设项目~~

摘　　要：目的分析70例经齐拉西酮治疗的精神分裂症患者疗效及锥体外系反应的相关因素。方法对70例经齐拉西酮治疗的精神分裂症患者的疗效及锥体外系反应的相关因素进行线性回归分析。结果疾病明显发作次数少是齐拉西酮疗效好的预测因素(β=-0.496,P=0.000);既往有无明显急性肌张力障碍和帕金森综合征、以阳性症状为主及疾病明显发作次数是有明显急性肌张力障碍和类帕金森综合征的预测因素(β分别为-0.634、0.332、-0.181,P分别为0.000、0.000、0.054);既往有明显静坐不能、疾病明显发作次数是明显静坐不能的预测因素(β分别为0.633、0.136,P分别为0.000、0.034)。阴性症状、病程长是齐拉西酮治疗有静坐不能的保护性因素(β分别为-0.310、-0.181,P分别为0.000、0.024)。结论疾病明显发作次数少的精神分裂症患者采用齐拉西酮治疗的疗效较好;既往有明显锥体外系反应史者、疾病明显发作次数少者应用齐拉西酮易发生明显锥体外系反应;以阴性症状为主、病程长的精神分裂症患者应用齐拉西酮不易发生静坐不能;以阳性症状为主者易发生急性肌张力障碍和类帕金森综合征。Objective To analyze factors related to efficacy of ziprasidone and extrapyramidal symptom（ EPS） in 70 schizophrenia patients treated with ziprasidone. Methods Multi linear Logistic regression was used to analyze factors related to efficacy of the treatment and extrapyramidal symptom in 70 schizophrenia patients treated with ziprasidone. Results Significant episodes of the disease were the predictor for the good effect of ziprasidone（ β =- 0. 496,P = 0. 000）. Previous history with acute dysmyotonia and Parkinson syndrome,prominent positive symptom,were the predictor for acute dysmyotonia and Parkinson syndrome（ β =- 0. 634,0. 332 respectively,P =0. 000 for both）. Previous history of akathisia,prominent positive symptom,and relapse time of disease were the predictor for akathisia（ β= 0. 633,0. 136 respectively,P = 0. 000,0. 034 respectively）,prominent negative symptom and duration of disease were the protective factors for akathisia（ β =- 0. 310,- 0. 181 respectively,P = 0. 000,0. 024 respectively）. Conclusion Schizophrenia patients with few relapses of disease will demonstrate good therapeutic effect when treated with ziprasidone. Schizophrenia patients with previous history of extrapyramidal symptom,or with fewer relapses of disease may show higher occurrence of EPS; patients with prominent negative symptom,long duration of disease may predict lower occurrence of akathisia. Patients with prominent positive symptom may predict higher occurrence of acute dysmyotonia and Parkinson syndrome.

关 键 词：精神分裂症 齐拉西酮 疗效 锥体外系反应 预测因素 

分 类 号：R749.05[医药卫生—神经病学与精神病学]