于足+杨淼

[摘要] 目的 探讨齐拉西酮与奥氮平治疗脑器质性精神病患者的临床疗效和安全性。 方法 选择2013年6月～2014年6月我院收治的脑器质性精神病患者87例，将其分为齐拉西酮组41例、奥氮平组46例，两组患者连续治疗8周，比较两组患者临床疗效、治疗中不同时间点简明精神病症状评分量表（BPRS）评分以及治疗中不良反应发生情况。 结果 齐拉西酮组患者治疗总有效率为90.24%，奥氮平组治疗总有效率为86.96%，两组治疗总有效率比较差异无统计学意义（P>0.05）；在治疗前、治疗1周及治疗8周，两组BRPS评分差异无统计学意义（P>0.05），而在治疗2周以及治疗4周，齐拉西酮组BRPS评分显著低于奥氮平组，差异有统计学意义（P<0.05）；奥氮平组体质量增加的发生率显著高于齐拉西酮组（P<0.05），而齐拉西酮组震颤的发生率显著高于奥氮平组（P<0.05），但经对症处理后，震颤均能有效缓解。 结论 齐拉西酮与奥氮平治疗脑器质性精神病具有相似的临床疗效，且用药安全性较高，但两者不良反应不同，在临床应用上应根据患者的身体状况选择用药。

[关键词] 齐拉西酮；奥氮平；脑器质性精神病；安全性

[中图分类号] R749.4 [文献标识码] B [文章编号] 1673-9701（2015）23-0104-04

Analysis of safety evaluation and clinical efficacy of ziprasidone and olanzapine in the treatment of brain organic mental disorder patients

YU Zu YANG Miao

Department of Geriatrics， Jinhua Second Hospital in Zhejiang Province， Jinhua 321000， China

[Abstract] Objective To investigate the clinical efficacy and safety evaluation of ziprasidone and olanzapine in treatment of organic brain mental patients. Methods All 87 cases of patients with brain organic mental disease were selected from our hospital during June 2013 and June 2014， they were divided into two groups， one was Olanzapine group （41 cases）， the other was Ziprasidone group（46 cases） ， two groups were treated for 8 weeks， and then the two groups were compared from the following factors： clinical efficacy in the treatment of different time points， 2the Brief Psychiatric symptom score（BPRS）， the incidence of adverse reaction scor. Results Ziprasidone groups total efficiency rate was 90.24%， Olanzapine group s total efficiency rate was 86.96%， Ziprasidone group was higher than Olanzapine group， the difference was not statistically significant （P>0.05）； In the time of before treatment， 1 weeks after treatment and 8 weeks after treatment， the two groupss BRPS score had no statistical difference（P>0.05）， and in the time of 2 weeks after treatment and 4 weeks after treatment， Ziprasidone groups BRPS score was significantly lower than Olanzapine group， and the difference was statistically significantly（P<0.05）； the incidence of increased body weight in Olanzapine group was significantly higher than Ziprasidone group（P<0.05）， while the incidence of tremor in Ziprasidone group was significantly higher than Olanzapine group （P<0.05）， but after symptomatic treatment， tremor effectively relieved. Conclusion In the treatment of brain organic mental disorder， Ziprasidone and Olanzapine have a similar clinical efficacy， and the drug safety of them is higher， but the adverse reactions of them are not the same， in the clinical application， Ziprasidone and Olanzapine should be selected according to the physical condition of patients.

[Key words] Ziprasidone； Olanzapine； Brain organic mental disorder； Safety

脑器质性精神病是临床精神医学上较为常见的一种疾病，其在脑器质性疾病当中具有较高的发病率，患者多伴有妄想、幻觉、兴奋躁动、思维形式障碍以及意志活动异常等临床症状，同时严重者还可能出现行为障碍、意识障碍、认知障碍等，甚至出现不同程度的人格改变[1，2]。患者病程迁延，随着疾病的发展可出现认知功能的损伤以及社会功能的缺陷，病情后期部分患者由于精神衰退而产生巨大的痛苦，病情严重者可失去劳动能力，加重了家庭以及社会的负担[3，4]。齐拉西酮以及奥氮平是临床中治疗脑器质性精神病的两种常用药物[5]，而目前对于两种药物治疗脑器质性精神病疗效及安全性的比较研究相对较少。本研……