3种药物治疗首发精神分裂症患者的疗效、安全性及认知功能对比分析

A comparative analysis of the efficacy, safety and cognitive function of three different drugs in the treatment of first-episode schizophrenia

摘要:

目的 探讨奥氮平、帕利哌酮缓释片、氨磺必利治疗首发精神分裂症患者的临床疗效、安全性及对认知功能的影响。方法 回顾性分析武汉市精神卫生中心2016年4月—2018年6月收治的141例首发精神分裂症患者的临床资料，将所选患者按照治疗方式的不同分为A、B、C组，每组各47例。A组给予帕利哌酮缓释片治疗，B组给予奥氮平治疗，C组给予氨磺必利治疗。比较分析各组患者的认知功能评分、临床症状评分、临床疗效及不良反应发生情况。结果 A组患者简明精神状态量表（MMSE）各维度评分均高于B组与C组患者（P?<0.05）；B组患者与C组患者MMSE量表的各维度评分比较，差异无统计学意义（P?>0.05）。治疗后，A组患者阳性与阴性症状量表（PANSS）评分的各维度分数及总分均低于B组与C组患者（P?<0.05），B组患者与C组患者PANSS评分各维度的分数及总分比较，差异无统计学意义（P?>0.05）。治疗后，各组患者的临床总有效率比较，差异无统计学意义（P?>0.05）。A组患者的不良反应发生率（8.51%）低于B组（27.66%）与C组患者（29.79%）（P?<0.05），但B组患者的不良反应发生率与C组患者比较，差异无统计学意义（P?>0.05）。结论 3种药物治疗首发精神分裂症患者都能获得较理想的疗效，帕利哌酮缓释片在改善临床症状，提高认知水平方面的价值优于奥氮平与氨磺必利，同时其肝功能异常较为少见，可适用于肝功能受损患者。

Abstract:

Objective To investigate the clinical efficacy, safety and cognitive function of olanzapine, paliperidone sustained-release tablets and amisulpride in the treatment of first-episode schizophrenia. Methods The clinical data of 141 cases of first-episode schizophrenia in our hospital were retrospectively analyzed. The selected patients were divided into A group, B group and C group according to different treatment methods, 47 cases in each group. A was treated with paliperidone sustained-release tablets, B with olanzapine and C with amisulpride. Cognitive function scores, clinical symptoms scores, clinical efficacy and adverse reactions of each group were compared and analyzed. Results The scores of MMSE dimensions in A group were higher than those in B group and C group, with statistical significance (P??0.05). After treatment, the PANSS scores of A group were lower than those of B group and C group, and the difference was statistically significant (P??0.05). After treatment, there was no significant difference in the total effective rate of each group (P?>?0.05). The incidence of adverse reactions in A group (8.51%) was lower than that in B group (27.66%) and C group (29.79%), and the difference was statistically significant (P??0.05). Conclusions Three drugs can obtain ideal curative effect in the treatment of first-episode schizophrenia. paliperidone sustained-release tablets are better than olanzapine and amisulfapride in improving clinical symptoms and cognitive level. At the same time, paliperidone sustained-release tablets mainly pass through kidney metabolism, rarely through liver metabolism, and can be applied to patients with impaired liver function.