齐拉西酮联合碳酸锂治疗双相障碍急性躁狂发作患者疗效及对血清Hcy、BDNF水平和认知功能的影响  

Effect of ziprasidone combined with lithium carbonate in the treatment of patients with bipolar disorder acute manic episode and the impact on serum Hcy and BDNF levels and cognitive function

作　　者：林荫[1] 赖珏 刘海雅 LIN Yin;LAI Jue;LIU Haiya(Department of Psychiatric,Hainan Anning Hospital,Haikou 570206,China)

机构地区：[1]海南省安宁医院精神科,海口570206

出　　处：《国际精神病学杂志》2024年第3期744-748,共5页Journal Of International Psychiatry

基　　金：海南省卫生健康行业科研项目(编号:21A200382)。

摘　　要：目的探讨齐拉西酮联合碳酸锂治疗双相情感障碍Ⅰ型急性躁狂发作患者疗效及对血清同型半胱氨酸(homocysteine,Hcy)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平和认知功能的影响。方法选取2021年1月~2023年12月102例双相情感障碍Ⅰ型急性躁狂发作患者,随机分为联合组52例与对照组50例。对照组采用碳酸锂治疗,联合组采用齐拉西酮联合碳酸锂治疗,疗程8周。比较两组疗效、血清Hcy和BDNF水平、贝克-拉范森躁狂量表评分(Bech-Rafaelsen mania rating scale,BRMS)、杨氏躁狂状态评定量表评分(young mania rating scale,YMRS)、神经心理状态评定量表评分(repeatable battery for the assessment of neuropsychological status,RBANS)、不良反应。结果联合组的治疗总有效率高于对照组(92.31%vs 74.00%,P<0.05)。联合组治疗后的血清Hcy水平低于对照组,BDNF水平高于对照组(P<0.05)。联合组治疗后的BRMS评分、YMRS评分低于对照组,RBANS评分高于对照组(P<0.05)。联合组和对照组的总不良反应率分别为13.46%和10.00%,两组不良反应比较无差异(P>0.05)。结论齐拉西酮联合碳酸锂显著提高临床疗效,改善中枢神经代谢和认知功能。Objective To investigate the effect of ziprasidone combined with lithium carbonate in the treatment of patients with bipolar disorder type I and acute manic episode,and analyze the impact on serum homocysteine(Hcy)and brain-derived neurotrophic factor(BDNF)levels and cognitive function.Methods 102 patients with bipolar disorder type I acute manic episodes from January 2021 to December 2023 were selected.They were randomly divided into the combination group(50 patients treated with ziprasidone combined with lithium carbonate)and the control group(50 patients treated with lithium carbonate).Both groups were treated for 8 weeks.The two groups were compared on therapeutic effects,serum Hcy and BDNF levels,Bech-Rafaelsen mania rating scale(BRMS)scores,young mania rating scale(YMRS)scores,repeatable battery for the assessment of neuropsychological status(RBANS)scores and adverse reactions.Results Compared with the control group,the efficiency of the combination group was higher(92.31%vs 74.00%,P<0.05).Compared with the control group,the Hcy level was lower and BDNF level was higher of the combination group(P<0.05).Compared with the control group,the combination group had lower BRMS score and YMRS score,and higher RBANS score(P<0.05).The total incidence rates of adverse reactions in the combination group and the control group were 13.46%and 10.00%,without significant difference between the groups(P>0.05).Conclusion Ziprasidone combined with lithium carbonate can significantly improve the therapeutic effect on bipolar disorder type I with acute manic episode,as well as central nervous system and cognitive function.

关 键 词：双相情感障碍Ⅰ型 躁狂发作 齐拉西酮 碳酸锂 同型半胱氨酸 脑源性神经营养因子 

分 类 号：R749.05[医药卫生—神经病学与精神病学]