基于药物基因组学探讨抗精神病药对首发精神分裂症疗效及不良反应的影响  

The efficacy and adverse events of antipsychotic drugs use on first-episode schizophrenias based on pharmacogenomic

作　　者：朱建南[1] 林晓方 王从杰[1] ZHU Jian-nan;LIN Xiao-fang;WANG Cong-jie(Department of Psychiatric,Huai'an Third People's Hospital,Huai’an 223001,China)

机构地区：[1]江苏省淮安市第三人民医院精神科,223001

出　　处：《临床精神医学杂志》2024年第4期280-284,共5页Journal of Clinical Psychiatry

基　　金：江苏省淮安市卫生健康委科研计划项目(HAWJ201918)。

摘　　要：目的:依据药物基因组学结果,探讨抗精神病药对首发精神分裂症患者疗效和药物不良反应的影响。方法:纳入2020年1月至2022年6月淮安市第三人民医院的首发精神分裂症患者,分为研究组和对照组各100例,研究组根据基因检测结果指导用药,对照组依据医师经验用药,分别于治疗前、治疗后4、8、12、16周使用阳性和阴性症状量表(positive and negative syndrome scale,PANSS)、临床疗效总评量表(clinical global impression,CGI)评定疗效,威斯康星卡片分类测验(Wisconsin card classification tests,WCST)及个人和社会功能评估量表(personal and social function assessment scales,PSP)评定认知及社会功能,并在治疗前后和两组之间比较,同时评定药物副反应量表(treatment emergent symptom scale,TESS)及作实验室检查,了解药物不良反应。结果:两组患者治疗后的PANSS总分、CGI、TESS、PSP、WCST等评分均较治疗前显著改善(P<0.05或P<0.001),研究组患者明显好于对照组(P<0.05或P<0.001),治疗后12~16周肝功能损害也轻于对照组,差异均有统计学意义(P<0.05或P<0.001)。血常规等实验室结果两组间差异无统计学意义(P>0.05)。结论:应用基因检测可提高精神分裂症患者药物治疗临床效果,减少不良反应的发生,指导临床合理、精准用药和个体化治疗。Objective:To explore the efficacy and adverse events of antipsychotic drugs use on first-episode schizophrenia according to the pharmacogenomics testing’s results.Method:Two hundreds cases of first-episode schizophrenia from January 2020 to June 2022,Huai'an Third People's Hospital were randomly divided into two groups:100 cases of study group and 100 cases of control group.The patinets in the study group treated under the guidance of gene detection,and the control group treated with the doctor's clinical experiences.Before and after treatment at 4,8,12 and 16 weeks,positive and negative symptom scale(PANSS),clinical global impression(CGI)were used to evaluate efficacy.Wisconsin card classification tests(WCST)and personal and social function assessment scales(PSP)were used to evaluate the cognitive and social function,and compared before and after treatment and between the two groups.Treatment emergent symptom scale(TESS),monitoring blood routine et al were used to compare the side effects of drugs,and compared between the two groups.Results:The scores of PANSS,CGI score,TESS score,PSP score,WCST score of two groups were improved significantly after treatment compared with pre-treatment(P<0.05 or P<0.001).These scores of study group were significantly better than those in the control group(P<0.05 or P<0.001).After treatment of 12 to 16 weeks,the liver function impairment was also significantly less than that in the control group(P<0.05 or P<0.001).There were no significant differences in blood routine et al(P>0.05)between the two groups.Conclusion:The application of gene detection can improve the clinical effect of drug therapy in schizophrenic patients,reduce the side effects of drugs,to guide clinical rational and precise drug use and individualized treatment.

关 键 词：基因检测 精神分裂症 临床疗效 药物不良反应 

分 类 号：R749.3[医药卫生—神经病学与精神病学]