氨磺必利与利培酮治疗老年精神分裂症的效果和安全性  

Comparing efficacy and safety of amisulpride and risperidone in the treatment of elderly schizophrenia

作　　者：赵燕[1] 

机构地区：[1]山东省泰安市复员退伍军人精神病院,山东泰安271000

出　　处：《四川精神卫生》2016年第6期534-537,共4页Sichuan Mental Health

摘　　要：目的比较氨磺必利和利培酮治疗老年精神分裂症的效果和安全性，为临床医生用药提供参考。方法按照《国际疾病分类（第10版）》诊断标准，在山东省泰安市复员退伍军人精神病院收集63例老年精神分裂症住院患者，将入组患者进行编号，采用随机数字表法将患者分为两组，分别给予氨磺必利（氨磺必利组，n=31）和利培酮（利培酮组，n=32）治疗，氨磺必利起始剂量50～100mg／d，第7—10天逐步增至100～600mg／d，利培酮起始剂量0．5～1mg／d，第7～10天逐步增至1-4mg／d。两组均有28例完成研究。分别于基线期和治疗1、2、4、6周后进行血压、脉搏、体重、血常规、心电图检测，于基线期和治疗6周后进行肝、肾功能、空腹血葡萄糖检测，使用阳性和阴性症状量表（PANSS）评定临床疗效，采用Simpson锥体外系副反应评定量表（SEPS）评定锥体外系副反应。结果氨磺必利组脱落率为9．7％，利培酮组脱落率为12．5％，两组脱落率比较差异无统计学意义（χ2=0.287，P〉0．05）。治疗6周后，氨磺必利组和利培酮组有效率（92．9％vs．89．3％，χ2=0.186，P〉0．05）及显效率（67．9％vs．67．9％，χ2=0．179，P〉0．05）差异均无统计学意义。治疗第1周末，氨磺必利组PANSS总评分与基线期比较，差异有统计学意义（P〈0．05），治疗第2周末，利培酮组PANSS总评分与基线期比较，差异有统计学意义（P〈0．05）。氨磺必利组和利培酮组不良反应发生率比较差异无统计学意义（50．0％vs．57．1％，χ2=0．462，P〉0．05）。结论氨磺必利与利培酮对老年精神分裂症总体疗效和安全性相当，但氨磺必利比利培酮起效更快。Objective To compare the efficacy and safety of amisulpride and risperidone in the treatment of elderly schizophrenia, and to provide reference for clinicians. Methods A total of 63 elderly patients with schizophrenia who met the diagnostic criteria of International Classification of Diseases, tenth edition （ICD - 10） were recruited in Taihn Veterans＇Mental Hospital of Shandong Province, and they were divided into two groups through the random number table method. Amisulpride group （n = 31 ） were treated with amisulpride and risperidone group （n = 32） for risperidone, respectively. Amisulpride were given start dose 50 - 100 mg/d, 7 - 10 days gradually increased to 100 - 600 mg/d, while starting dose of risperidone were 0.5 - 1 mg/d, 7 - 10 days gradually increased to 1 -4 mg/d. There were 28 cases completed the research in each group. The blood pressure, pulse, body weight, blood routine, ECG were tested at the baseline and the 1st, 2nd, 4th, 6th week after treatment, and the liver function, kidney function, and fasting blood glucose were measured at the baseline and the 6th week after treatment. Positive and Negative Symptom Scale （PANSS） was used to evaluate the clinical efficacy, and Simpson Extrapyramidal Scale （SEPS） was used to evaluate extrapyramidal side effects. Results The dropout rate of amisulpride group was 9.7% , and risperidone group was 12.5%. There was no difference between two groups in dropout rate （χ2 = 0. 287, P 〉 0.05 ）. After 6 weeks of treatment, the effective rate of amisulpride group and risperidone group were 92.9% and 89.3% , respectively （χ2 = 0, 186, P 〉 0.05 ） , the markedly effective rate were 67.9% and 67.9% , there was no significant difference between two groups （χ2 = 0. 179, P 〉 0.05 ）. Comparing with the baseline, the total score of PANSS at the 1 st weekend was lower in amisulpride group （P 〈 0.05 ）, while the significant difference appeared at the 2nd weekend in the risperidone group. There was no significant difference in the

关 键 词：氨磺必利 利培酮 精神分裂症 临床疗效 安全性 

分 类 号：R749.3[医药卫生—神经病学与精神病学]