低浓度七氟烷辅助治疗精神疾病急性期患者的效果:单臂、开放试验  

Efficacy of low-concentration sevoflurane as an adjunct for treatment of patients with acute mental disorders:a single-arm,open-label,pilot study

作　　者：赵天云[1] 凌秾喜 石子文 杨孝 周权才 王远胜 秦静文 徐彩媚 张文华[1] 魏伟[1] 林传松 宋兴荣[1] Zhao Tianyun;Ling Nongxi;Shi Ziwen;Yang Xiao;Zhou Quancai;Wang Yuansheng;Qin Jingwen;Xu Caimei;Zhang Wenhua;Wei Wei;Lin Chuansong;Song Xingrong(Department of Anesthesiology,Guangzhou Women and Children′s Medical Center,Guangzhou Medical University,Guangzhou 510623,China;Department of Psychiatry,the Third People′s Hospital of Xinhui District,Jiangmen 529100,China;Department of Anesthesiology,Jiangmen Central Hospital Affiliated Jiangmen Hospital of Sun Yat-Sen University,Jiangmen 529030,China)

机构地区：[1]广州医科大学附属广州市妇女儿童医疗中心麻醉科,510623 [2]江门市新会区第三人民医院精神科,529100 [3]中山大学附属江门医院,江门市中心医院麻醉科,529030

出　　处：《中华麻醉学杂志》2020年第12期1494-1498,共5页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金面上项目(81671116,81870823);广州市科技计划项目(201803010025);儿研所/妇儿中心内部基金(GCP-2018-001)。

摘　　要：目的评价低浓度七氟烷辅助治疗精神疾病急性期患者的效果。方法选择精神疾病急性期住院患者,在常规抗精神病药物治疗的基础上,每隔1~2 d吸入0.5%~1.5%七氟烷5 h,2周内治疗6次。采用临床总体印象量表-疾病严重程度(CGI-S)评分评估治疗前疾病严重程度。采用临床总体印象量表-总体改善(CGI-I)评分评定治疗1、2周时的疗效,CGI-I评分≤2分为治疗有效。记录治疗过程中血压、心率、SpO2、心电图、实验室指标(血常规、肝肾功能)和治疗期间不良事件发生情况。结果本试验共纳入精神分裂症患者10例、双相障碍患者4例、重型抑郁症2例。所有患者入院时CGI-S评分≥5分。治疗1周时治疗有效率为56%,治疗2周时治疗有效率75%。治疗期间血压、心率平稳,实验室检查结果未见肝功能损害发生;仅1例精神分裂症患者在第1次治疗后出现轻度体位性低血压,其余患者治疗期间未见治疗期间不良事件发生。结论低浓度(0.5%~1.5%)七氟烷辅助治疗对精神疾病急性期患者安全有效。Objective To evaluate the efficacy of low-concentration sevoflurane as an adjunct for the treatment of patients with acute mental disorders.Methods Hospitalized patients who were taking antipsychotics and experiencing an acute exacerbation of psychosis inhaled 0.5%-1.5%sevoflurane for 5 h every 1-2 days,and this treatment was repeated for 6 times within 2 weeks.Clinical Global Impressions-Severity of Illness scale(CGI-S)was used to evaluate the severity of the disease before treatment,while CGI-Improvement scale(CGI-I)was used to evaluate the therapeutic effects at week 1 and week 2.Early response was defined as CGI improvement score of 1 or 2.Blood pressure,heart rate,oxygen saturation(SpO2),electrocardiogram(ECG),laboratory tests(blood routine,liver and kidney function)and Treatment Emergent Adverse Events were recorded during the treatment.Results A total of 16 patients experiencing an acute exacerbation with mental disorders were enrolled,including 10 patients with schizophrenia,4 patients with bipolar disorder and 2 patients with major depression.The CGI-S score was≥5 in all the patients on admission to hospital.At week 1 of the treatment,early response rate was 56%.At week 2 of the treatment,early response rate was 75%.In terms of safety,the blood pressure and heart rate were stable,and no hepatic function damage was found during the treatment.No Treatment Emergent Adverse Events occurred except that one patient with schizophrenia developed mild orthostatic hypotension after the first inhalation of sevoflurane.Conclusion Low-concentration sevoflurane(0.5%-1.5%)is safe and effective when used as an adjunct for the treatment of the patients with acute mental disorders.

关 键 词：精神疾病 七氟烷 

分 类 号：R614[医药卫生—麻醉学]