黎海雁 李志东 陈慧武

[摘要]目的分析評估首发精神分裂症治疗期间应用棕榈酸帕利哌酮的临床治疗效果。方法选择2019年1月至2020年5月云浮市（罗定）第三人民医院精神二科收治的72例首发精神分裂症患者作为研究对象，根据随机数字表法划分为对照组（ n=36）和观察组（ n=36），对照组应用药氨磺必利片，观察组应用棕榈酸帕利哌酮。分析患者是否出现锥体外系反应、头晕、便秘、呕吐以及体重增加5%以上等症状，比较两组患者治疗效果，评估指标包含阳性和阴性综合征量表（PANSS）、不良反应发生情况、个人和社会功能量表（PSP）、临床总体印象量表（CGI）、复发情况。结果治疗前，两组患者 PANSS、PSP 和 CGI 评分比较差异无统计学意义（ P >0.05）;在治疗3、6以及12个月后，观察组 PANSS 评分低于对照组，观察组 PSP、CGI 评分高于对照组，差异有统计学意义（ P <0.05）;两组患者不良反应发生率比较，差异无统计学意义（ P >0.05）;观察组复发率低于对照组，差异有统计学意义（ P <0.05）。结论首发精神分裂症治疗期间应用棕榈酸帕利哌酮对于促进个人以及社会功能恢复具有积极意义，用药安全性比较高，在改善患者阴性以及阳性症状的同时有效控制病情复发率，降低了患者临床总体印象评分，不会增加不良反应发生率，在临床上可借鉴推广。

[关键词]棕榈酸帕利哌酮;首发精神分裂症;不良反应;阴性以及阳性症状

[中图分类号] R749.3 [文献标识码] A  [文章编号]2095-0616（2021）22-0065-04

Evaluation of paliperidone palmitate in the treatment of first- episode schizophrenia

LI  Haiyan   LI  Zhidong   CHEN  Huiwu

The Second Department of Psychiatry， the Third People's Hospital of Yunfu （Luoding）， Guangdong， Yunfu527200，China

[Abstract] Objective To analyze and evaluate the clinical therapeutic effect of paliperidone palmitate during the treatment of first-episode schizophrenia. Methods A total of 72 patients with first-episode schizophrenia admitted to the Second Department of Psychiatry， the Third People's Hospital of Yunfu （Luoding） from January 2019 to January 2020 were selected as the research objects， and they were divided into the control group （n=36） and the observation group （n=36） according to the random number table method. The control group was given sulfanilamide tablets， while the observation group was given paliperidone palmitate. The patients were analyzed for extrapyramidal reaction， dizziness， constipation， vomiting， and body weight increased by more than 5%. The therapeutic effects of the two groups were compared. The evaluation indexes included Positive and negative symptom scale （PANSS）， occurrence of adverse reactions， personal social performance （PSP） scale， clinical global impressions （CGI） Scale and the incidence of relapse were compared between two groups. Results Before treatment， there was no significant difference in PANSS，PSP and CGI scores between the two groups （P >0.05）. After 3 months， 6 months and 12 months of treatment， the scores of PANSS in the observation group was lower than those in the control group，the score of PSP and CGI in the observation group were higher than that in the control group， with statistically significant differences （P <0.05）. There was no significant difference in the probability of adverse reactions between the two groups （P >0.05）. The recurrence rate of observation group was lower than that of control group， with statistically significant difference （P <0.05）. Conclusion The application of paliperidone palmitate during the treatment of first-episode schizophrenia has positive significance in promoting the recovery of personal and social functions， and has high medication safety. It can effectively control the relapse rate while improving the negative and positive symptoms of patients， reduce the overall clinical impression score of patients， and will not increase the incidence of adverse reactions， which can be used for reference in clinical practice.

[Key words] Paliperidone palmitate; First-episode schizophrenia; Adverse reactions; Positive and negative symptoms

精神分裂症属于目前在临床实践过程中最为常见的慢性高致残性精神类疾病，在疾病发生以后患者表现为思维、行为以及情感紊乱和认知功能受损等症状，目前针对精神分裂症主要采取抗精神病类药物，但是部分患者采取常规药物治疗以后效果不佳，需要选择治疗效果理想以及安全性较高的药物长期持续治疗，以期控制病情稳定、避免疾病复发[1]。目前在精神分裂症治疗期间不仅强调药物治疗效果，是否可以改善患者社会功能以及促使患者回归至正常生活属于首发精神分裂症治疗的终极目标[2]。经典……