喹硫平联合碳酸锂治疗青少年双相情感障碍Ⅰ型躁狂相的疗效及对患者认知功能和生活质量的影响  

Curative effect of quetiapine combined with lithium carbonate for adolescent bipolar disorder typeⅠmanic phase and its effect on cognitive function and quality of life of patients

作　　者：张华 王斌[1] 付佳佳 孟苓苓 王晓明 宋雯[1] ZHANG Hua;WANG Bin;FU Jiajia;MENG Lingling;WANG Xiaoming;SONG Wen(Department of Psychiatry,the Eighth Hospital of Shijiazhuang,Shijiazhuang 050081,Hebei Province,China)

机构地区：[1]石家庄市第八医院精神病科,河北石家庄050081

出　　处：《新乡医学院学报》2023年第9期840-845,850,共7页Journal of Xinxiang Medical University

基　　金：石家庄市科学技术研究与发展计划项目(编号:21461343)。

摘　　要：目的探讨喹硫平联合碳酸锂治疗青少年双相情感障碍Ⅰ型躁狂相的疗效及对患者认知功能及生活质量的影响。方法选择2019年2月至2020年2月石家庄市第八医院精神病科收治的74例青少年双相情感障碍Ⅰ型躁狂相患者为研究对象,按照简单随机化法将患者分为对照组和观察组,每组37例。对照组患者给予碳酸锂治疗,疗程为8周;观察组患者给予喹硫平联合碳酸锂治疗,疗程为8周。采用倍克-拉范森躁狂评定量表(BRMS)评分评估2组患者治疗前后躁狂严重程度,采用临床总体印象-双相情感障碍疾病严重程度量表(CGI-BP-s)评分评估2组患者治疗前后双相障碍严重程度,采用生活质量综合评定问卷-74(GQOLI-74)评分评估2组患者治疗前后的生活质量,采用可重复的成套神经心理状态测验(RBANS)评分评估2组患者的认知功能。比较2组患者的疗效及治疗期间不良反应发生情况。结果治疗前,2组患者的BRMS、CGI-BP-s、各项GQOLI-74评分及各项认知功能评分比较差异均无统计学意义(P>0.05)。治疗后,2组患者的BRMS、CGI-BP-s评分显著低于治疗前(P<0.05),各项GQOLI-74评分、各项认知功能评分显著高于治疗前(P<0.05)。治疗后,对照组患者中显效13例,有效14例,无效10例,总有效率为72.97%(27/37);观察组患者中显效19例,有效13例,无效5例,总有效率为86.49%(32/37);观察组患者的总有效率显著高于对照组(χ^(2)=3.331,P<0.05)。对照组患者发生腹泻2例,便秘1例,恶心呕吐2例,头晕嗜睡2例,震颤1例,乏力4例,口干1例,不良反应发生率为35.14%(13/37);观察组患者发生腹泻2例,便秘1例,恶心呕吐3例,头晕嗜睡1例,低血压2例,震颤1例,乏力3例,口干1例,不良反应发生率为37.84%(14/37);2组患者的不良反应发生率比较差异无统计学意义(χ^(2)=0.778,P>0.05)。结论喹硫平联合碳酸锂治疗青少年双相情感障碍I型躁狂相的效果优于单纯碳酸锂治疗,能有效�Objective To investigate the curative effect of quetiapine combined with lithium carbonate for adolescent bipolar disorder type I manic phase and its effect on cognitive function and quality of life of patients.Methods A total of 74 adolescent patients with bipolar disorder typeⅠmania admitted to the Department of Psychiatry,the Eighth Hospital of Shijiazhuang from February 2019 to February 2020 were selected as the research objects.According to the simple randomization method,they were divided into the control group and the observation group,with 37 cases in each group.The patients in the control group were treated with lithium carbonate for 8 weeks;the patients in the observation group were treated with quetiapine combined with lithium carbonate for 8 weeks.The severity of mania of patients in the two groups was evaluated by using the Bech-Rafaelsen mania rating scale(BRMS)score before and after treatment;the severity of bipolar disorder of patients in the two groups was evaluated by using the clinical global impression-bipolar disorder-severity of illness scale(CGI-BP-s)score before and after treatment;the quality of life of patients in the two groups was evaluated by using the generic quality of life inventory-74(GQOLI-74)score before and after treatment;the cognitive function of patients in the two groups was evaluated by using the repeatable battery for the assessment of neuropsychological status(RBANS)score.The efficacy and the occurrence of adverse reactions during treatment of patients were compared between the two groups.Results Before treatment,there was no significant difference in BRMS,CGI-BP-s,each GQOLI-74 scores and each cognitive function scores of patients between the two groups(P>0.05).After treatment,BRMS and CGI-BP-s scores of patients in the two groups were significantly lower than those before treatment(P<0.05),each GQOLI-74 scores and each cognitive function scores were significantly higher than those before treatment(P<0.05).After treatment,in the control group,13 cases were excellent,1

关 键 词：双相情感障碍 躁狂 青少年 喹硫平 碳酸锂 

分 类 号：R749.4[医药卫生—神经病学与精神病学]