奥氮平与阿立哌唑对精神分裂症患者血尿酸水平的影响及其临床疗效  

Effect of Olanzapine and Aripiprazole on Serum Uric Acid Level in Patients with Schizophrenia

作　　者：张瑞丹 张传波[2] 马新越 匡丹 朱振梅 王培培 ZHANG Ruidan;ZHANG Chuanbo;MA Xinyue;KUANG Dan;ZHU Zhenmei;WANG Peipei(Weifang Medical University,Weifang 261000,China;Weifang Mental Health Center,Weifang 261072,China;Department of Clinical Psychology,Weifang People′s Hospital,Weifang 261000,China;Department of Psychiatry,Shaoxing Seventh People′s Hospital,Shaoxing 312099,China;Department of Psychology,Linqu County Psychiatric Hospital,Linqu 262600,China)

机构地区：[1]潍坊医学院,山东潍坊261000 [2]潍坊市精神卫生中心,山东潍坊261072 [3]潍坊市人民医院临床心理科,山东潍坊261000 [4]绍兴市第七人民医院精神科,浙江绍兴312099 [5]临朐县精神病院精神科,山东临朐262600

出　　处：《医学综述》2023年第20期4375-4379,4385,共6页Medical Recapitulate

摘　　要：目的探究口服奥氮平与阿立哌唑对精神分裂症(SCZ)患者血尿酸水平的影响及其临床疗效。方法选择2021年1月至2022年10月潍坊市精神卫生中心收治的160例SCZ患者作为研究对象,按照治疗方法分为奥氮平组(80例)和阿立哌唑组(80例),比较两组患者治疗前后血尿酸水平、阳性和阴性症状量表(PANSS)评分、临床疗效、蒙特利尔认知功能评定量表(MoCA)评分及不良事件发生率。结果治疗前后血尿酸的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间血尿酸的主效应差异有统计学意义(P<0.01);血尿酸的时点间与组间存在交互作用(P<0.01),两组治疗前后血尿酸的变化幅度不同。奥氮平组治疗后第8周、第12周血尿酸水平均高于治疗前(P<0.01),治疗后第4周、第8周、第12周,阿立哌唑组血尿酸水平均低于奥氮平组[(274±28)μmol/L比(344±33)μmol/L、(292±24)μmol/L比(425±33)μmol/L、(305±16)μmol/L比(532±18)μmol/L](P<0.05)。治疗后,两组PANSS评分均低于治疗前(P<0.05),且阿立哌唑组PANSS评分高于奥氮平组[(47±10)分比(44±6)分](P<0.01)。两组临床治疗总有效率比较差异无统计学意义[96.25%(77/80)比95.00%(76/80)](χ^(2)=1.356,P=0.781),两组临床疗效比较差异无统计学意义(Z=-2.237,P=0.062)。治疗后,两组MoCA评分均高于治疗前(P<0.01),但两组治疗后MoCA评分比较差异无统计学意义(P>0.05)。阿立哌唑组不良事件发生率低于奥氮平组[18.75%(15/80)比8.75%(7/80)](χ^(2)=4.949,P=0.026)。结论奥氮平与阿立哌唑治疗SCZ的临床疗效无明显差异,但奥氮平可导致血尿酸水平升高,且不良反应略多于阿立哌唑。Objective To explore the effects of oral olanzapine and aripiprazole on blood uric acid levels in patients with schizophrenia(SCZ)and their clinical efficacy.Methods A total of 160 SCZ patients admitted to Weifang Mental Health Center from Jan.2021 to Oct.2022 were included,and divided into an olanzapine group(80 cases)and an aripiprazole group(80 cases)according to the treatment method.The blood uric acid levels before and after treatment,positive and negative symptom scale(PANSS),clinical efficacy,Montreal cognitive assessment(MoCA)and incidence of adverse events of the two groups were compared.Results The main effect difference of serum uric acid before and after treatment was statistically significant(P<0.01).Regardless of the measurement time,the main effect difference of serum uric acid between the two groups was statistically significant(P<0.01).There was interaction between the time points and groups(P<0.01),and the change amplitude of blood uric acid before and after treatment was different in the two groups.The serum uric acid level in the olanzapine group at 8th and 12th week after treatment was higher than that before treatment(P<0.01).At 4,8,and 12 weeks after treatment,serum uric acid levels in the aripiprazole group were lower than those in the olanzapine group[(274±28)μmol/L vs(344±33)μmol/L,(292±24)μmol/L vs(425±33)μmol/L,(305±16)μmol/L vs(532±18)μmol/L](P<0.05).After treatment,PANSS scores in both groups were lower than before treatment(P<0.05),and PANSS scores in the aripiprazole group were higher than the olanzapine group(47±10 vs 44±6)(P<0.01).There was no significant difference in the total effective rate between the two groups[96.25%(77/80)vs 95.00%(76/80)](χ^(2)=1.356,P=0.781),and there was no significant difference in clinical efficacy between the two groups(Z=-2.237,P=0.062).After treatment,MoCA scores in both groups were higher than before treatment(P<0.01),but there was no significant difference in MoCA scores between the two groups after treatment(P>0.05).The incidence

关 键 词：精神分裂症 奥氮平 阿立哌唑 血尿酸 

分 类 号：R284.1[医药卫生—中药学] R917.101[医药卫生—中医学]