帕利哌酮联合右佐匹克隆治疗精神分裂症伴睡眠障碍疗效及对患者神经功能睡眠质量血清催乳素C反应蛋白的影响  

Effects of paliperidone combined with dexzopiclone in the treatment of schizophrenia with sleep disorders and on neurological function,sleep quality,serum PRL and CRP

作　　者：颜铁论 谢何杰 吴秋琳 陈卫丰 Yan Tielun;Xie Hejie;Wu Qiulin;Chen Weifeng(Department of Laboratory,Lishui Second People′s Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市第二人民医院检验科,浙江丽水323000

出　　处：《中国药物与临床》2024年第12期774-780,共7页Chinese Remedies & Clinics

基　　金：浙江省医药卫生科技计划项目(2024KY1877)。

摘　　要：目的探讨帕利哌酮联合右佐匹克隆治疗精神分裂症伴睡眠障碍疗效及对患者神经功能、睡眠质量、血清催乳素(PRL)、C反应蛋白(CRP)水平的影响。方法选取2021年7月至2023年12月丽水市第二人民医院收治的精神分裂症伴睡眠障碍患者92例,按治疗方法分为联合组(46例,奇号)和对照组(46例,偶号),对照组服用帕利哌酮联合劳拉西泮治疗,联合组服用帕利哌酮联合右佐匹克隆治疗,于治疗前和治疗4、8和12周后评估2组精神分裂症状[采用阴性和阳性症状量表(PANSS)]评分变化,神经功能治疗前后变化[蒙特利尔认知评估量表(MoCA)和简易精神状态评定表(MMSE)]、睡眠质量改善情况[匹兹堡睡眠质量指数(PSQI)]、脑神经营养指标变化[脑源性神经营养因子(BDNF)、神经营养因子3(NT-3)、多巴胺(DA)、5-羟色胺(5-HT)]水平及血清催乳素(PRL)、C反应蛋白(CRP)水平变化,统计治疗期间不良反应情况。结果治疗4周、8周、12周后,2组PANSS评分均逐渐降低,组内不同时间点比较,差异有统计学意义(P<0.05),且联合组治疗4周(46±5)、8周(40±4)及12周(32±4)后低于对照组(48±5、42±4、34±4,P<0.05);治疗12周后,2组患者MoCA、MMSE评分均下降(P<0.05),且联合组[MoCA(12.5±1.5)、MMSE(12.1±1.0)]低于对照组[MoCA(18.2±2.0);MMSE(17.6±1.6)](P<0.05);治疗12周后,2组患者PSQI评分均下降(P<0.05),且联合组[睡眠质量(0.85±0.12);入睡时间(0.98±0.24);睡眠时间(0.97±0.18);睡眠效率(0.86±0.14);睡眠障碍(0.88±0.07);日间功能(0.79±0.18)]低于对照组[睡眠质量(1.02±0.47);入睡时间(1.04±0.34);睡眠时间(1.05±0.38);睡眠效率(1.03±0.56);睡眠障碍(1.01±0.41);日间功能(1.01±0.57)](P<0.05);治疗12周后,2组血清BDNF、NT-3、DA、5-HT含量均高于治疗前(P<0.05),且联合组[BDNF(4715±138)ng/ml,NT-3(179±18)ng/ml,DA(71±7)ng/ml,5-HT(44±7)ng/ml]明显高于对照组[BDNF(4218±162)ng/ml,NT-3(150±16)ng/ml,DA(61±6)ng/ml,5-HT(36±5)ng/ml]Objective To explore the efficacy of paliperidone combined with dexzopiclone in the treat-ment of schizophrenia with sleep disorders and its effects on neurological function,sleep quality,serum prolactin(PRL)and C-reactive protein(CRP).Methods A total of 92 patients with schizophrenia and sleep disorders ad-mitted to Lishui Second People′s Hospital from July 2021 to December 2023 were selected as the study subjects.They were divided into a combination group(n=46)and a control group(n=46),according to different treatment methods.The control group was treated with paliperidone combined with lorazepam while the combined group were given paliperidone combined with dexzopiclone.Before the treatment and after 4 weeks,8 weeks and 12 weeks of the treatment,evaluate the changes of these symptoms:the schizophrenic symptoms[Positive and Nega-tive Syndrome Scale(PANSS)],neurological function[Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)],brain neurotrophic indicators[brain-derived neurotrophic factor(BDNF),neurotrophin-3(NT-3),dopamine(DA),5-hydroxytryptamine(5-HT)],levels of serum PRL and CRP.The adverse reactions during treatment were counted.Results After 4 weeks,8 weeks and 12 weeks of the treatment,the PANSS scores of the two groups were gradually decreased,and there was a statisti-cal difference at different time points within the same group(P<0.05).The scores after 4 weeks,8 weeks and 12 weeks of the treatment in the combination group[(46±5)points,(40±4)points,and(32±4)points]were significant-ly lower than those in the control group[(48±5)points,(42±4)points,and(34±4)points](P<0.05).After 12 weeks of the treatment,the MoCA and MMSE scores of both groups of patients significantly decreased(P<0.05),and the scores in the combination group[MoCA(12.5±1.5);MMSE(12.1±1.0)]were significantly lower than those in the control group[MoCA(18.2±2.0);MMSE(17.6±1.6)](P<0.05).After 12 weeks of treatment,the PSQI scores of both groups of patients

关 键 词：棕榈酸帕利哌酮 右佐匹克隆 精神分裂症 睡眠障碍 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R740[医药卫生—临床医学]