齐拉西酮联用奥氮平对精神分裂症疗效及糖化血红蛋白的影响

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摘要目的：探讨齐拉西酮早期联用奥氮平治疗精神分裂症的疗效以及对血糖和糖化血红蛋白的影响。方法：选择自2013年1月至2014年1月期间7家精神卫生医院确诊精神分裂症患者197例作为观察对象，随机分为单药组（齐拉西酮99例）和联用组（齐拉西酮联用奥氮平98例），2组治疗起始5周均以齐拉西酮联用奥氮平，5周后单药组渐停奥氮平，联用组继续联用奥氮平治疗，均持续12周时间。比较2组在治疗前及治疗后1、5、7、9、12周末PANSS量表评定结果，以及空腹血糖及糖化血红蛋白数值。结果：2组治疗后的PANSS评分均有显著下降，差异有统计学意义（P＜0.05）；各时点2组间的PANSS量表评分差异无统计学意义（P＞0.05）。而空腹血糖在第9、第12周末时，联用组血糖升高更明显，两者差异有统计学意义（P＜0.05）；糖化血红蛋白在各时点的变化，差异无统计学意义（P＞0.05）。结论：单用齐拉西酮与齐拉西酮联用奥氮平的疗效相当，后期以齐拉西酮单药维持有利于血糖的控制，而且病情相对稳定。

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	周勇1
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	黄汉津1
	唐建良3

关键词 ：精神分裂症, 齐拉西酮, 奥氮平, 代谢综合征, 糖化血红蛋白

Abstract：Objective: To explore the efficacy of ziprasidone and olanzapine in treating patients with schizophrenia and their influences on blood glucose and glycosylated hemoglobin at early stage of course of treatment. Methods: 197 cases of schizophrenia patients were randomly divided into experimantal group (99 cases administered only with ziprasidone) and control group (98 cases administered with ziprasidone and olanzapin). All the patients were selected from 7 different psychiatric hospital who were diagnosed from 2013.1-2014.1. Both groups were administered with olanzapin and olanzapine at the first 5 weeks. Then olanzapine was abandoned gradually in experimental group, while the control group went on its original treatment both groups were treated for 12 weeks. Scores of PANSS, level of blood glucose and glycosylated hemoglobin were compared between the two groups before treatment and the 1st, 5st, 7st, 9st, 12st weekend after treatment. Results: Both groups showed significant decrease after the treatment (P<0.05), but there’s no statistical difference at every time point (P>0.05). The level of limosis blood glucose in control group was higher than that in experimental group at the 9th and 12th weekend (P<0.05). There’s no statistical difference at the level of glycosylated hemoglobin in both groups by every time point (P>0.05). Conclusion: The efficacy of single ziprasidone and combination treatment is similar, but single ziprasidone at later stage shows more benefit for blood glucose control and meanwhile shows relatively reliable efficacy.

Key words： schizophrenia ziprasidone olanzapine metabolic syndrome glycosylated hemoglobin

收稿日期: 2015-03-05

基金资助:嘉兴市科技计划项目（2014AY21064）。

通讯作者: 黄汉津，主任医师，硕士生导师，Email：hhj@wmu.edu.cn。

作者简介: 周勇（1979-），男，安徽淮南人，副主任医师，在职硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2015/V45/I9/674

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