帕利哌酮与利培酮治疗老年精神分裂症的对照研究  

Controlled study of paliperidone and risperidone in the treatment of senile schizophrenia

作　　者：蔡清艳 李洪毅 简薇[1] 阮熙 王晓燕 欧阳艾莅 Cai Qingyan;Li Hongyi;Jian Wei;Ruan Xi;Wang Xiaoyan;Ouyang Aili(The Fourth People＇s Hospital of Chengdu, Chengdu 610036, China)

机构地区：[1]成都市第四人民医院,四川成都610036

出　　处：《四川精神卫生》2018年第4期348-352,共5页Sichuan Mental Health

摘　　要：目的比较帕利哌酮缓释片与利培酮治疗老年精神分裂症的效果和安全性,为老年精神分裂症的药物治疗提供参考。方法于2014年3月-2015年12月在成都市第四人民医院就诊者中筛选126例符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)诊断标准的、年龄≥60岁的老年精神分裂症患者,按计算机随机法分为帕利哌酮组和利培酮组各63例,分别给予帕利哌酮缓释片和利培酮治疗,两组疗程均为180天。于基线期及治疗第1、2、4、8、12周末、180天时采用阳性和阴性症状量表(PANSS)、副反应量表(TESS)评定疗效和不良反应,并进行心电图和肝功监测。结果共107例完成研究,帕利哌酮组54例,利培酮组53例。分别从治疗第1、2周末开始,帕利哌酮组和利培酮组各治疗时点PANSS总评分与基线期比较,差异均有统计学意义(P均<0.05),两组各治疗时点PANSS总评分比较差异均有统计学意义(P<0.05或0.01);治疗第180天,帕利哌酮组痊愈率高于利培酮组,差异有统计学意义(79.63%vs.62.27%,P<0.05)。整个治疗期间,帕利哌酮组锥体外系副反应(EPS)发生率低于利培酮组,差异有统计学意义(9.26%vs.24.53%,P<0.05)。结论帕利哌酮与利培酮均能改善老年精神分裂症患者的精神症状,但帕利哌酮起效更快,疗效更佳,安全性更好。Objective To compare the efficacy and safety between paliperidone and risperidone in the treatment of senile schizophrenia,so as to provide references for drug treatments of the disease. Methods The participants were 126 elderly patients with schizophrenia（ age≥60 years） in the Fourth People’s Hospital of Chengdu from March 2014 to December 2015. Their symptoms were in line with the schizophrenia criteria in Diagnostic and Statistical Manual of Mental Disorders,fourth edition（ DSM-IV）.Participants were randomly divided into two groups（ 63 participants in each group）,and were treated with paliperidone and risperidone respectively for 180 days. Positive and Negative Syndrome Scale（ PANSS） and Treatment Emergent Symptom Scale（ TESS） were used to evaluate the clinical efficacy and side effects at the baseline and 1 st,2 nd,4 th,8 th,12 thweekend,180 thdays respectively after treatment started. At the same time,all participants were examined by electrocardiogram and accepted liver function monitor.Results 107 patients has completed the study,the paliperidone group were 54 cases while the risperidone group were 53 cases.Compared with the baseline,the total score of PANSS of paliperidone group was statistically different since the 1 stand 2 ndweekend,the risperidone group showed significant statistical difference（ P 〈 0. 05）. Besides,the total score of PANSS between the two groups showed statistically significant difference at each observed time（ P 〈 0. 05 or 0. 01）. At the 180 thday of treatment,the cure rate of paliperidone group was higher than risperidone group（ 79. 63% vs. 62. 27%）,and the difference was significant（ P 〈 0. 05）. During the treatment,the incidence of extrapyramidal symptoms（ EPS） of paliperidone group was lower than that of the risperidone group（ 9. 26% vs. 24. 53%,P 〈 0. 05）. Conclusion Both paliperidone and risperidone can improve the mental symptoms of senile schizophrenia,but paliperidone works faster,better and safer.

关 键 词：帕利哌酮缓释片 利培酮 老年精神分裂症 

分 类 号：R749.3[医药卫生—神经病学与精神病学]