关力杰 老帼慧

【摘要】 目的：研究分析齊拉西酮、奥氮平联合治疗老年难治性精神分裂症的效果及对神经营养因子、神经生长因子水平的影响。方法：选取2018年7月-2019年7月于笔者所在医院就诊的60例难治性精神分裂症老年患者为研究对象，采用随机数字表法分为对照组（n=30）和试验组（n=30），对照组给予奥氮平治疗，试验组给予齐拉西酮联合奥氮平治疗，比较两组患者治疗后临床疗效、认知功能改善情况、神经营养因子（BDNF）、神经生长因子（NGF）及胶质纤维酸性蛋白（GFAP）水平。结果：治疗后试验组临床总有效率高于对照组，差异有统计学意义（P<0.05）。治疗后试验组认知功能改善情况优于对照组，差异有统计学意义（P<0.05）。治疗后试验组BDNF、NGF、GFAP水平高于对照组，差异有统计学意义（P<0.05）。结论：齐拉西酮、奥氮平联合治疗老年难治性精神分裂症临床效果良好，可有效改善老年患者认知功能，提高血清中神经营养因子及神经生长因子水平。

【关键词】 奥氮平 齐拉西酮 难治性精神分裂症

doi：10.14033/j.cnki.cfmr.2020.20.008 文献标识码 B 文章编号 1674-6805（2020）20-00-03

The Effect of Ziprasidone and Olanzapine Combination Therapy and Influence on the Level of Neurotrophic Factor and Nerve Growth Factor in the Elderly Patients with Refractory Schizophrenia/GUAN Lijie， LAO Guohui. //Chinese and Foreign Medical Research， 2020， 18（20）： -24

[Abstract] Objective： To study and analyze the effect of Ziprasidone and Olanzapine combination therapy and influence on the level of neurotrophic factor and nerve growth factor in the elderly patients with refractory schizophrenia. Method： A total of 60 elderly patients with refractory schizophrenia who were treated in our hospital from July 2018 to July 2019 were selected as the research objects. They were divided into the control group （n=30） and the experimental group （n=30） by random number table method. The control group was treated with Olanzapine， and the experimental group was treated with Ziprasidone combined with Olanzapine. The clinical effect and cognitive function improvement and BDNF， NGF and GFAP levels of the two groups were compared. Result： The total clinical effective rate of the experimental group was higher than that of the control group， the difference was statistically significant （P<0.05）. The improvement of cognitive function in the experimental group was better than that in the control group， the difference was statistically significant （P<0.05）. The levels of BDNF， NGF and GFAP in the experimental group were higher than those in the control group， the difference were statistically significant （P<0.05）. Conclusion： The combination of Ziprasidone and Olanzapine has a good clinical effect in the treatment of refractory schizophrenia in the elderly. It can effectively improve the cognitive function of the elderly patients and the level of serum neurotrophic factor and nerve growth factor.

[Key words] Olanzapine Ziprasidone Refractory schizophrenia

First-authors address： Brain Hospital Affiliated to Guangzhou Medical University， Guangzhou 510370， China

难治性精神分裂症病程较长且病情反复，临床表现为思维、感知、行为及情感等方面异常，严重影响患者正常社会功能。随着社会发展，我国老年精神分裂患者明显增加[1]。目前常采用非典型抗精神疾病药物奥氮平进行治疗，但是老年患者多数伴有糖尿病、高血压、高血脂、冠心病等慢性基础疾病，单纯奥氮平治疗，部分患者耐受性较差，而齐拉西酮可抑制去甲肾上腺素再摄取，可明显改善患者阴性表现，而且对于糖脂代谢影响较小[2]。近年来笔者在临床中发现齐拉西酮、奥氮平联合治疗老年难治性精神分裂症临床症状缓解明显，今为进一步探讨二者联合应用对患者认知功能、神经营养因子及神经生长因子水平影响，遂进行本次研究。

1 资料与方法

1.1 一般……