甲磺酸齐拉西酮对老年精神分裂症患者的临床疗效

Clinical evaluation of ziprasidone mesylate in the treatment of elderly patients with schizophrenia

摘要:

目的 探讨甲磺酸齐拉西酮治疗精神分裂症患者急性激越症状的临床效果。方法 选取2016年1月至2017年12月在四川省广元市精神卫生中心接受治疗的老年精神分裂症患者72例。采用随机数字表法将患者分为甲磺酸齐拉西酮组、氟哌啶醇组各36例。甲磺酸齐拉西酮组患者给予注射用甲磺酸齐拉西酮5～10 mg/次,肌内注射,每日总量不大于 20 mg；氟哌啶醇组患者给予常规氟哌啶醇针剂5 mg/次,肌内注射,每日总量不大于10 mg。记录并比较2组患者治疗前及治疗72 h的阳性和阴性症状量表(PANSS)、临床疗效总体印象量表之病情严重程度(CGI-SI)评分,以及治疗前(T₀)和治疗后2 h(T₁)、8 h(T₂)、24 h(T₃)、48 h(T₄)、72 h(T₅)阳性和阴性症状量表中的兴奋因子(PANSS-EC)评分。采用SAS 9.0软件进行统计分析。根据数据类型,组间比较采用独立样本t检验或χ²检验,治疗前后比较采用配对t检验。结果 治疗前及治疗72 h后的2组患者PANSS及CGI-SI评分比较,差异无统计学意义(P>0.05),治疗72 h后,2组患者PANSS及CGI-SI评分较治疗前均显著降低,差异有统计学意义(P<0.05)。治疗前、后各时间点2组患者PANSS-EC评分差异无统计学意义(P>0.05)；与T₀比较,T1-5各时间点2组患者PANSS-EC评分均显著降低,差异有统计学意义(P<0.05)；与T₁比较,T2-5各时间点2组患者PANSS-EC评分均显著降低,差异亦有统计学意义(P<0.05)。与氟哌啶醇组比较,甲磺酸齐拉西酮组患者肌强直[2.78%(1/36) vs 16.67%(6/36)]、震颤[2.78%(1/36) vs 19.44%(7/36)]、流涎[5.56%(2/36) vs 22.22%(8/36)]、头颈部运动[2.78%(1/36) vs 19.44%(7/36)]等副反应发生率显著降低,差异有统计学意义(P<0.05)。结论 甲磺酸齐拉西酮治疗精神分裂症急性激越症状患者的效果与常规氟哌啶醇相似,同时具有副作用发生率较低的优点。

Abstract:

Objective To investigate the clinical efficacy of ziprasidone mesylate in the treatment of acute exacerbation of schizophrenia. Methods Enrolled in this clinical study were 72 elderly patients with schizophrenia treated in the Department of Psychiatry of Sichuan Provincial Guangyuan Mental Health Center from January 2016 to December 2017, who were randomly divided into ziprasidone mesylate group and haloperidol group with 36 patients in each group. In the former, ziprasidone mesylate 5-10 mg once, no more than 20 mg every day was administered intramuscularly. In the latter, haloperidol 5 mg once, no more than 10 mg every day was administered intramuscularly. The two groups were compared in the positive and negative symptoms scale (PANSS) and clinical global impression-severity of illness (CGI-SI) before and up to 72 h after treatment, and positive and negative symptoms scale-excited component (PANSS-EC) before treatment (T₀) and at 2 h (T₁), 8 h (T₂), 24 h (T₃), 48 h (T₄), and 72 h (T₅) after treatment. SAS statistics 9.0 was used for statistical analysis. Depending on data type, independent sample t test or Chi-square test was used for intergroup comparison, and paired t test for comparison before and after treatment. Results There was no significant difference in PANSS and CGI-SI scores between the two groups before treatment and up to 72 h after treatment (P>0.05). PANSS and CGI-SI scores for two groups at 72 h after treatment were significantly lower than those before treatment (P<0.05). There was no significant difference in PANSS-EC scores between two groups at each time point before and after treatment (P<0.05). PANSS-EC scores at T1-5 were significantly lower than those at T₀ (P<0.05), and PANSS-EC scores at T2-5 were significantly lower than those at T₁, the differences being statistically significant (P<0.05). Compared with haloperidol group, the ziprasidone mesylate group had significantly lowerincidence of side effects, including myotonia [2.78%(1/36) vs 16.67%(6/36)], tremor [2.78%(1/36) vs 19.44%(7/36)], rogue [5.56%(2/36) vs 22.22%(8/36)], and head and neck movement [2.78%(1/36) vs 19.44%(7/36)], the differences being statistically significant (P<0.05). Conclusion Ziprasidone mesylate has similar efficacy in the treatment of acute agitation symptoms of schizophrenia compared with conventional haloperidol treatment and has low incidences of side effects.