不同剂量奥氮平对脑血管病所致精神障碍患者Hcy、ox-LDL水平及认知功能的影响  

Comparison of the effects of two doses of olanzapine on the levels of Hcy,ox-LDL and cognitive function in patients with cerebrovascular disease

作　　者：曾明礼 刘小梅 王瑶 ZENG Mingli;LIU Xiaomei;WANG Yao(Department of Neurology,Leshan Geriatric Hospital,Leshan 614000,China)

机构地区：[1]乐山老年病专科医院神经内科,乐山614000

出　　处：《国际精神病学杂志》2025年第1期213-216,共4页Journal Of International Psychiatry

基　　金：乐山市卫生健康委重点研究项目(编号:19SZD174)。

摘　　要：目的 对比不同剂量奥氮平治疗脑血管病所致精神障碍时对患者血清同型半胱氨酸(Homocysteine,Hcy)、氧化低密度脂蛋白(Oxidized Low Den-Sity Lipoprotein,ox-LDL)水平及认知功能的影响。方法 将我院2019年12月~2022年12月的122例脑血管病所致精神障碍患者,随机分为两组,低剂量组和高剂量组,每组61例。低剂量组给药5 mg/d;高剂量组给药10 mg/d,治疗周期为8周。对比两组治疗前后临床表现、简明精神病评定量表(Brief Psychiatric Rating Scale,BRPS)和阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、Hcy、ox-LDL水平。结果低剂量组总有效率83.6%(51/61),高剂量组总有效率82.0%(50/61);治疗后两组BRPS、PANSS评分均较治疗前降低;治疗后两组Hcy、ox-LDL水平显著降低,治疗后低剂量组Hcy、ox-LDL水平比高剂量组更低。结论 奥氮平可用于脑血管病所致精神障碍,两种剂量效果相当,从用药安全性来看,小剂量更值得推荐。Objective To compare the effects of two doses of olanzapine in the treatment of mental disorders caused by cerebrovascular disease on serum homocysteine(Homocysteine,Hcy),oxidized low-density lipoprotein(Oxidized Low Den-Sity Lipoprotein,ox-LDL)levels and cognitive function.Methods A total of 122 patients with mental disorders caused by cerebrovascular disease who visited our hospital from December 2019~December 2022 were included in this study,and were divided into two groups,low-dose group and high-dose group,with 61 cases in each group.5 mg/day in the low-dose group;The high-dose group administered 15 mg/day for 8 weeks.The clinical manifestations,Brief Psychiatric Rating Scale(BRPS)and Positive and Negative Syndrome Scale(PNASS)scores,Hcy and ox-LDL levels before and after treatment were compared between the two groups.Results The total effective rate was 83.6%(51/61)in the low-dose group and 75.4%(46/61)in the high-dose group.The BRPS and PANSS scores of the two groups after treatment were lower than those before treatment.The levels of Hcy and ox-LDL were significantly reduced in the two groups after treatment,and the levels of Hcy and ox-LDL in the low-dose group after treatment were lower than those in the high-dose group.Conclusion The olanzapine can be used for mental disorders caused by cerebrovascular disease,the two doses have comparable effects,and from the perspective of drug safety,small doses are more recommended.

关 键 词：脑血管病所致精神障碍 奥氮平 用药安全 药物剂量 

分 类 号：R749[医药卫生—神经病学与精神病学]