齐拉西酮在难治性精神分裂症患者无抽搐电休克治疗中的效果及对泌乳素的影响  

Effects of ziprasidone in electroconvulsive treatment in refractory schizophrenia patients and its effect on prolactin

作　　者：许跃华 邵三勤 Xu Yuehua;Shao Sanqin(Department of Psychiatric,Second People′s Hospital of Shangqiu,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市第二人民医院精神科,河南商丘476000

出　　处：《中国药物与临床》2024年第21期1406-1410,共5页Chinese Remedies & Clinics

摘　　要：目的探讨在齐拉西酮治疗的前提下,难治性精神分裂症患者加用无抽搐电休克治疗的效果,以期为临床治疗提供参考和依据。方法本研究共纳入河南省商丘市第二人民医院2021年5月至2023年5月92例难治性精神分裂患者,进行前瞻性研究。将所有患者按照随机数字表法分为对照组(46例,采用齐拉西酮治疗)和研究组(46例,采用齐拉西酮联合无抽搐电休克治疗)。2组患者均进行为期2个月的治疗。将2组患者治疗前后阳性与阴性症状量表(PANSS)评分、血清学指标以及治疗安全性进行对比。结果治疗后研究组患者的临床总有效97.8%相较于对照组患者的临床总有效率80.4%提高(χ^(2)=7.180,P<0.05);治疗后2组患者PANSS各项评分均相较于治疗前下降,且研究组患者阴性症状评分相较于对照组下降(t=10.168,P均<0.05),而治疗后2组患者阳性症状、一般精神病理症状及PANSS总分经对比,差异无统计学意义(t=0.240、0.053、0.108,均P>0.05);治疗后2组患者血清泌乳素(PRL)、雌二醇(E_(2))、睾酮指标水平均相较于治疗前升高,研究组患者PRL指标水平相较于对照组下降(t=23.847,均P<0.05);研究组患者不良反应总发生率(4.4%)相较于对照组(21.7%)下降(χ^(2)=6.133,P<0.05)。结论在接受齐拉西酮治疗的前提下,临床治疗难治性精神分裂症患者时,加用无抽搐电休克治疗可使患者各项临床症状得以缓解,降低血清PRL指标水平,疗效确切,且安全性较高。ObjectiveTo explore the effect of adding no convulsions of electroconvulsive therapy in patients with refractory schizophrenia under the premise of ziprasidone treatment,in order to provide reference and basis for clinical treatment.MethodsA total of 92 patients with refractory schizophrenia who were treated in the Second People′s Hospital of Shangqiu from May 2021 to May 2023 were selected for a prospective study.All the patients were divided into a control group(46 cases,treated with ziprasidone)and a study group(46 cases,treated with ziprasidone combined with non-convulsive electroconvulsive therapy)using a random number table method.Both groups were treated for two months.The positive and negative symptom scale(PANSS)scores,serological parameters,and treatment safety were compared between the two groups.ResultsThe clinical total effective rate of the study group after treatment(97.8%)was significantly higher than that of the control group(80.4%)(χ^(2)=7.180,P<0.05).After treatment,the PANSS scores of both groups of patients decreased compared to before treatment,and the negative symptom scores of the study group were significantly lower than those of the control group(t=10.168,both P<0.05).After treatment,there was no significant difference in positive symptoms,general psychopathological symptoms,and PANSS total score between the two groups of patients(t=0.240,0.053,0.108,all P>0.05).After treatment,the levels of serum prolactin(PRL),estradiol(E_(2)),and testosterone in both groups of patients were significantly higher than before treatment.The PRL levels in the study group were significantly lower than those in the control group(t=23.847,all P<0.05).The total incidence of adverse reactions in the study group(4.4%)was significantly lower than that in the control group(21.7%)(χ^(2)=6.133,P<0.05).ConclusionOn the premise of ziprasidone treatment,the addition of non-convulsive electroconvulsive therapy in the clinical treatment of refractory schizophrenia patients can alleviate various clinical symptoms,redu

关 键 词：精神分裂症 难治性 电惊厥疗法 治疗效果 泌乳素 齐拉西酮 

分 类 号：R749.3[医药卫生—神经病学与精神病学]