首发精神分裂症患者不同非典型抗精神病药物治疗的疗效及安全性对比观察  

Comparative Observation of the Efficacy and Safety of Different Atypical Antipsychotic Medications in Patients with First⁃Episode Schizophrenia

作　　者：李蕊 梁云 LI Rui;LIANG Yun(Sanmenxia Rehabilitation Hospital Psychiatric Department,Sanmenxia,Henan 472000,China)

机构地区：[1]三门峡市康复医院精神科,河南三门峡472000

出　　处：《今日药学》2024年第12期937-941,共5页Pharmacy Today

摘　　要：目的 探究首发精神分裂症患者使用不同非典型抗精神病药物进行治疗的疗效,并对其安全性进行观察。方法 选取2021年4月~2023年4月在某院接受治疗的93例首发精神分裂症患者,双色球法进行分组(准备93个球,46个红色代表A组,47个蓝色代表B组;将球放入不透明容器中混合,然后盲选球以分组,每个球代表1名患者,记录每次抽取的结果,确保过程可追溯):A组(n=46)接受齐拉西酮治疗,B组(n=47)接受利培酮治疗,治疗周期为8周。评估两组在阳性和阴性症状量表(PANSS)以及简明精神病评定量表(BPRS)上的评分情况,记录患者治疗前及治疗8周后相关点位P300波幅及潜伏期变化情况及血清脑源性神经营养因子(BDNF)、胶质源性神经营养因子(GDNF)水平变化,并使用不良反应量表(TESS)评估在治疗期间的不良反应。结果 两组治疗前后的PANSS评分在各时间段组间比较差异均无统计学意义(P>0.05),随着时间推移,两组的阳性症状、阴性症状及精神病理评分均逐步降低,时间对其具有显著影响(P<0.05),经重复测量方差分析,组间与时间之间无显著交互作用(P>0.05);两组患者BPRS评分在治疗前、治疗后各个时间段差异均无统计学意义(P>0.05),随着时间推移,两组的BPRS评分均逐渐降低,时间对其影响显著(P<0.05),但组间与时间无显著交互作用(P>0.05);治疗前两组患者的P300潜伏期及波幅比较差异均无统计学意义(P<0.05),治疗8周后,A组P300潜伏期较治疗前降低,P300波幅较治疗前升高(P<0.05),B组P300潜伏期及波幅与治疗前比较差异无统计学意义(P>0.05),治疗8周后,B组的P300潜伏期较A组升高,P300波幅较A组降低(P<0.05);治疗前两组患者的血清BDNF、GDNF水平差异均无统计学意义(P>0.05),治疗后,两组患者的血清BDNF、GDNF水平均升高,但B组低于A组(P<0.05);对两组患者的TESS不良反应评估结果进行统计学分析,A组患者体质量增加、月经紊乱�OBJECTIVE To explore the efficacy and safety of different atypical antipsychotic drugs in treating first⁃episode schizophrenia.METHODS This study selected 93 first⁃episode schizophrenia patients treated at the hospital from April 2021 to April 2023.Patients were randomly assigned into two groups using a two⁃color ball method(93 balls,46 red for Group A and 47 blue for Group B.The balls were mixed in an opaque container and drawn blindly to assign patients to groups,with each ball representing one patient,and the process was recorded to ensure traceability),Group A(n=46)received quetiapine treatment,and Group B(n=47)received risperidone treatment,with an 8⁃week treatment period.The study analyzed changes in positive and negative symptom scales(PANSS)and Brief Psychiatric Rating Scale(BPRS)scores,P300 wave amplitude and latency,as well as serum levels of Brain⁃Derived Neurotrophic Factor(BDNF)and Glial Cell Line⁃Derived Neurotrophic Factor(GDNF)before and after treatment.Adverse reactions were assessed using the Treatment Emergent Symptom Scale(TESS).RESULTS There were no significant differences between the groups in PANSS scores at any time point(P>0.05).Over time,both groups showed a gradual decrease in positive and negative symptoms and BPRS scores,with a significant effect of time(P<0.05).No significant interaction between group and time was observed(P>0.05).Pre⁃treatment comparisons of P300 latency and amplitude showed no differences(P>0.05).However,post⁃treatment,Group A showed a decrease in P300 latency and an increase in amplitude(P<0.05),while Group B showed no significant changes.Post⁃treatment,Group B's P300 latency was higher and amplitude lower compared to Group A(P<0.05).Serum BDNF and GDNF levels increased in both groups after treatment,with Group B showing lower levels than Group A(P<0.05).Statistical analysis of adverse reactions assessed by TESS showed the incidence of weight gain and menstrual disorders in group A was lower than that in Group B,with no significant difference in

关 键 词：首发精神分裂症 齐拉西酮 利培酮 疗效 认知功能 

分 类 号：R969[医药卫生—药理学]