| 靳西龙.帕利哌酮针剂与利培酮对精神分裂症急性期血浆泌乳素及社会功能的影响[J].浙江中西医结合杂志,2015,25(4): |
| 帕利哌酮针剂与利培酮对精神分裂症急性期血浆泌乳素及社会功能的影响 |
| Impact ofSpaliperidoneSinjection and risperidone on social function and plasmaSprolactin forSpatients of acute schizophrenia |
| 投稿时间：2014-06-24 修订日期：2014-11-04 |
| DOI： |
| 中文关键词: 精神分裂症 棕榈酸帕利哌酮 泌乳素 社会功能 |
| 英文关键词:Schizophrenia Paliperidone palmitate Prolactin Social functioning |
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| 中文摘要: |
| 目的 比较棕榈酸帕利哌酮与利培酮对精神分裂症患者血浆催乳素及社会功能的影响。方法 将76例急性精神分裂症患者随机分为帕利哌酮针组(38例,棕榈酸帕利哌酮治疗)和利培酮组(38例,利培酮治疗),于基线,治疗后第4,8,16周末检测患者的血浆泌乳素水平,于分组前和分组后8周、16周以个人和社会功能量表(Personal and Social Performance, PSP)评定患者的社会功能,以阳性和阴性症状量表(PANSS)、临床疗效总评量表中的病情严重程度(GGI-SI)及Simpson锥体外系副反应评定量表(SEPS)评定疗效和不良反应。结果 帕利哌酮针组38例患者中,有31例(81.6% )完成研究,利培酮组38例患者中,有32例(84.2% )完成研究,将完成全部研究的患者的资料纳入统计分析。分组前两组的PNASS、CGI-SI及SEPS评分比较均无统计学差异。分组治疗16周后,两组的PANSS评分及CGI-SI评分均下降,但两组间比较无统计学差异；帕利哌酮针组、利培酮组的SEPS评分的均数(标准差)为3.6(2.7)和5.2(2.5), (t=2. 11,P=0. 041)。分组治疗8周后,帕利哌酮针组与利培酮组的血浆催乳素均数(标准差)分别为41.2.(18. 7)μg/L及48. 5(16. 5)μg/L,(t=2. 42,P=0. 014),两组的PSP评分的均数(标准差)分别为69. 5(9. 2)及64. 7(12. 1), (t=2. 21,P=0. 042)；分组16周后,帕利哌酮针组与利培酮组的血浆催乳素浓度的均数(标准差)分别为40. 5(17. 5)μg/L及61. 5(19.5)μg/L,(t=6.55,P<0. 001),两组的PSP评分的均数(标准差)分别为80. 4(6. 4)及65. 9(9.2),(t=6.52,P<0. 001)。两组血浆催乳素水平的差异有统计学意义(F=4. 62,P=0. 032),两组PSP分值的差异有统计学意义(F=8.24,P=0.005)。结论 棕榈酸帕利哌酮可有效改善急性精神分裂症患者的症状、社会功能,安全性好。椎体外系不良反应较轻,高催乳素血症的程度较低,社会功能恢复较好。 |
| 英文摘要: |
| [Abstract] Objective: To compare effects of paliperidone palmitate and risperidone on plasma prolactin and social functioning in schizophrenia patients. Methods: Seventy-six patients with acute schizophrenia were randomly divided into paliperidone injection group (38 cases, treated with injection of paliperidone palmitate) and risperidone oral group (38 cases, treated with oral risperidone). Plasma prolactin level were assessed at baseline and 4, 8, and 16 weeks post-treatment. Social functioning was evaluated using the Personal and SocialPerformance (PSP) pre-randomization and 8 weeks and 16 weeks after randomization. Clinical effectiveness and side effects were evaluated by comparing pre-randomization and 16-week post-randomization values of the Positive And Negative Symptoms Scale (PANSS), the Severity Index of the Clinical Global Inventory (CGI-SI) and the Simpson Extrapyramidal Scale (SEPS). Results: 31 (81.6% ) of the 38 patients in the paliperidone injection group and 32 ( 84.2% ) of the 38 patients in the oral risperidone group completed the trial, and data of all the patients who completed the study included in the statistical analysis. There were no statistical differences between groups in the pre-treatment values of PANSSS, CGI-SI or SEPS. After16 weeks of treatment the PANSS and CGI-SI showed significant improvement in both groups, but there was no significant difference between the two groups. However, the mean (sd) post-treatment SEPS score was significantly lower in the injection group than in the oral treatment group [3.6(2.7) vs5.2(2. 5),t=2.11,P=0.041]. After 8 weeks of treatment, mean serum prolactin levels in the injection and oral administration groups were 41.2 (18. 7) and 48.5 (16.5) μg/L, respectively (t=2.42,P=0.014); and the mean PSP scores were 69. 5(9.2) and 64.7 (12.1), respectively (t=2.21,P=0.042). After 16 weeks of treatment serum prolactin concentrations were 40.5 (17.5) and 61.5 (19.5) μg/L, respectively (t=6.55,P<0.001); and mean PSP scores were 80.4(6.4) and 65.9(9.2), respectively (t=6.52,P<0. 001). The pre-post change in prolactin concentration was significantly smaller in the injection group (F=4.64,P=0.032) and the pre-post change in PSP scores was significantly greater in the injection group (F= 8.24,P= 0. 005). Conclusion: Paliperidone palmitate can effectively improve the symptoms and social functions of acute schizophrenia, and has good security. It also has a mild extrapyramidal adverse reactions, a lower degree of hyperprolactinemia, and better social functional recovery. |
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