张 涛

（山西省太原市精神病医院，山西 太原 030045）

齐拉西酮治疗奥氮平所致体质量增加临床评价

张 涛

（山西省太原市精神病医院，山西 太原 030045）

目的探讨齐拉西酮治疗奥氮平所致精神分裂症患者体质量增加的疗效及安全性。方法 选取医院收治的精神分裂症住院患者80例，按随机数字表法分为干预组（奥氮平联合齐拉西酮治疗）和对照组(奥氮平治疗），各40例。分别于基线、12周末由2位精神科工作人员独立采用盲法评定体质量、体质量指数（BMI）和不良反应量表（TESS）情况。所有结局指标由SPSS 19．0软件进行意向性分析（ITT分析）。结果 研究过程中共脱落4例患者（5．00%），且两组脱落率无统计学差异(P＞0．05)；治疗12周末，干预组患者体质量变化值为（ －0．6±5．9）kg，BMI变化值为（ －0．5±2．7）kg／m2，明显低于对照组的（2．0±5．2）kg和（1．0±3．7）kg／m2（P＜0．05）；干预组和对照组最常见的不良反应均为锥体外系反应（3例比2例），且多为短暂的一过性反应；两组不良反应发生率无显著性差异（P＞0．05）。结论 齐拉西酮能显著改善奥氮平所致精神分裂症患者体质量增加问题，且安全性佳，但临床进一步推广应用需循证医学支持。

齐拉西酮；精神分裂症；奥氮平；体质量增加；体质量指数；临床疗效

Abstract：Ob jective To investigate the clinical efficacy and safety of ziprasidone in treating schizophrenia inpatients with weight gain induced by olanzapine．M ethods Totally 80 inpatients with schizophrenia admitted to our hospital were random ly divided into the intervention group（olanzapine combined with ziprasidone）and the control group（olanzapine），40 cases in each group．Body weight，body mass index（BMI），and treatment emergent symptom scale（TESS）in two groups were blindingly assessed by two independent psychiatric staffs at baseline and treatment endpoint（12 weeks）．All outcomes were analyzed using intention－to－treat（ITT）analysis by SPSS19．0 software．Results In this study，4 cases of discontinuation(5．00%)were found，and there was no difference between the two groups（P＞0．05）．At 12 weeks，the change of body weight and BMI in the intervention group were（－0．6±5．9）kg and（－0．5±2．7）kg／m2，which were significantly lower than（2．0±5．2）kg and（1．0±3．7）kg／m2in the control group（P＜0．05）．The most common adverse reactions in the intervention group and the control group were extrapyramidal（3 cases vs．2 cases），and most of them were transient reactions，there was no significant difference in the incidence rate of adverse reactions between the two groups（P＞0．05）．Conclusion Ziprasidone in treating schizophrenia inpatients with weight gain induced by olanzapine has good effect and safety，but further clinical application should be supported by evidence－based medicine．

Key words：ziprasidone；schizophrenia；olanzapine；weight gain；body mass index；clinical effect

精神分裂症属重性精神疾病，具有高复发率、高自伤自杀率和高住院率等风险，患者需长期服用抗精神病药物[1－2]。奥氮平是临床广泛用于治疗精神分裂症的非典型抗精神病药物，但易引起药源性肥胖。Curtis等[3]研究发现，首发精神分裂症患者接受奥氮平治疗3个月后，其体质量增加不低于7%的患者高达75%。……