精神分裂症兴奋激越患者从齐拉西酮注射剂转换为口服制剂的序贯治疗研究——一项1年的临床病例汇总分析

发布时间：2018-05-19 01:40

本文选题：精神分裂症 + 激越　；参考：《中国新药与临床杂志》2017年01期

【摘要】：目的探讨齐拉西酮注射液治疗精神分裂症激越症状后序贯至齐拉西酮口服药物的疗效与安全性。方法将122例经齐拉西酮注射液治疗有效的精神分裂症兴奋激越症状患者按临床决策自然分为口服齐拉西酮组(62例)与口服利培酮/奥氮平组(60例)。以阳性与阴性症状量表(PANSS)减分率评定疗效,以社会功能缺陷筛查量表(SDSS)评定社会功能,以监测心电图、催乳素、血糖、血脂变化及副反应量表(TESS)评定不良反应。结果齐拉西酮注射液治疗72 h后PANSS兴奋因子评分明显下降(P0.01);序贯至口服用药后,口服齐拉西酮组与口服利培酮/奥氮平组在临床治愈率、有效率、PANSS量表评分及SDSS量表评分方面无显著差异(均P0.05),但口服齐拉西酮组月经紊乱(催乳素升高)、体重增加、血脂代谢异常及血糖升高、锥体外系反应等不良反应发生率明显低于口服利培酮/奥氮平组(均P0.05)。口服齐拉西酮服药依从性更好,治疗8个月后中断率更低(P0.05);生存分析也表明两组治疗中断率有显著差异(P0.05)。结论齐拉西酮注射液治疗精神分裂症激越症状后序贯至口服齐拉西酮后长期疗效好,且不良反应少、依从性好、治疗中断率低,更利于维持期的治疗。
[Abstract]:Objective to investigate the efficacy and safety of ziprasidone injection in the treatment of schizophrenic agitation symptoms after sequential ziprasidone oral administration. Methods 122 patients with excitatory agitation symptom treated by ziprasidone injection were divided into two groups according to clinical decision: 62 cases of oral ziprasidone group and 60 cases of oral risperidone / olanzapine group. The efficacy was assessed with the positive and negative symptom scale (PANSS), the social function was assessed with the social function screening scale (SDSS), and the adverse reactions were assessed by ECG, prolactin, blood glucose, blood lipid and side effects. Results the score of PANSS excitatory factor of ziprasidone injection decreased significantly 72 hours after treatment, and the clinical cure rate of Ziprasidone group and risperidone / olanzapine group was significantly lower than that of oral ziprasidone group after oral administration of ziprasidone and risperidone / olanzapine. There was no significant difference in the effective rate of PANSS scale and SDSS scale (all P 0.05), but the menstrual disorder (prolactin increased, weight gain, dyslipidemia and blood sugar increased) in the oral ziprasidone group. The incidence of adverse reactions such as extrapyramidal reaction was significantly lower than that in risperidone / olanzapine group (all P 0.05). Oral ziprasidone had better compliance, and the interruption rate was lower after 8 months of treatment, and survival analysis showed that there was a significant difference between the two groups in the treatment interruption rate. Conclusion Ziprasidone injection has good long-term curative effect after sequential treatment of schizophrenia agitation symptom and oral ziprasidone, with less adverse reactions, good compliance, low treatment interruption rate, and is more favorable for the treatment of maintenance period.
【作者单位】：天津市安定医院心境障碍科;
【分类号】：R749.3

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