蔡荣　李少梅　梁健

【摘要】 目的 探討阿立哌唑联合小剂量氯氮平对首发精神分裂症患者精神症状及并发症的影响。方法 选取2014年12月～2017年7月87例首发精神分裂症患者，按照随机数字表分为观察组（n=44）与对照组（n=43）。对照组给予小剂量氯氮平治疗，观察组给予小剂量氯氮平+阿立哌唑治疗，均连续治疗8周。对比两组治疗前后阳性与阴性症状评分（PANSS）、临床疗效，统计两组治疗期间并发症（头晕/头痛、体重增加、恶心/呕吐、心电图异常、嗜睡等）发生率。结果 治疗前两组PANSS评分比较无统计学意义（P>0.05），治疗第4周、第8周较治疗前均显著降低（P<0.05），且观察组治疗第4周、第8周PANSS评分均低于对照组（P<0.05）；观察组临床疗效优于对照组，总有效率（93.18%vs74.42%）较对照组高（P<0.05）；观察组头晕/头痛、体重增加、恶心/呕吐、心电图异常、嗜睡等发生率与对照组比较无统计学意义（P>0.05）。结论 首发精神分裂症患者给予阿立哌唑联合小剂量氯氮平治疗，疗效显著，可有效缓解患者精神症状，且具有一定安全性。

【关键词】 首发精神分裂症；阿立哌唑；小剂量氯氮平；PANSS评分；并发症

中图分类号：R749.3 文献标识码：A DOI：10.3969/j.issn.1003-1383.2018.04.015

【Abstract】 Objective To investigate the influence of aripiprazole combined with low dose clozapine for PANSS score and complications in patients with first-episode schizophrenics.Methods 87 patients with first-episode schizophrenics from December 2014 to July 2017 were selected and randomly divided into observation group（n=44） and control group（n=43） according to random number table.The control group were treated with low dose clozapine，while the observation group were treated with low dose clozapine combined with aripiprazole，and the two groups were treated for 8 weeks.Then，the positive and negative symptom score （PANSS），clinical effects of the two groups before and after treatment were compared，and the incidence of complications（dizziness/headache，weight gain，nausea/vomiting，electrocardiogram abnormality and somnolence，etc） of the two groups were statistically analyzed.Results There was no statistically significant difference in the PANSS between the two groups before treatment（P>0.05）.At the 4th week and 8th week of treatment，they significantly reduced（P<0.05），and those of the observation group were all lower than those of the control group（P<0.05）.The clinical effect in the observation group was more significant than that in the control group，and the total effective rate was 93.18%，which was higher than that（74.42%） in the control group（P<0.05）.The incidence of dizziness/headache，weight gain，nausea/vomiting，electrocardiogram abnormality and somnolence in the observation group were not significantly different from those in the control group（P>0.05）.Conclusion The clinical effects of aripiprazole combined with low dose clozapine in patients with first-episode schizophrenics are significant，which can effectively relieve the mental symptoms of the patients with certain safety.

【Key words】 first-episode schizophrenics；aripiprazole；low dose clozapine；PANSS score；complications

精神分裂症是临床常见的一种精神疾患，近年该病发病率随着生活、工作、学习等压力增大而不断上升，严重影响着患者身心健康及生存质量[1]。药物治疗可缓解精神分裂症大部分症状，故抗精神病药物治疗是临床治疗首发精神分裂症的首选治疗措施[2～3]。氯氮平为苯二氮卓类抗精神病药物，可较强阻滞脑内多巴胺（DA）受体及5-羟色胺（5-HT）受体，同时具有抗α-肾上腺素受体、抗组胺、抗胆碱等作用，且对脑干网状结构上行激活系统有直接抑制作用，故催眠镇静效果显著，对精神分裂症阳性症状及阴性症状均有效。阿立哌唑是一种新型……