阿立哌唑与氯氮平对慢性精神分裂症患者疗效及脂质指标的影响比较

杨崇添 黄永倩 何燕杏

【摘要】 目的：对比阿立哌唑与氯氮平对慢性精神分裂症患者疗效及脂质指标的影响。方法：选取2016年5月-2017年5月本院收治的慢性精神分裂症患者72例。按照随机抽签法将其均分成试验组与对照组，各36例。对照组给予氯氮平治疗，试验组予以阿立哌唑治疗，比较两组临床疗效，治疗前后脂质指标水平（TG、TC、LDL-C、HDL-C）、生活质量变化情况以及不良反应。结果：试验组总有效率为97.22%，高于对照组的83.33%（P<0.05）;治疗后，试验组TG低于对照组（P<0.05），两组TC、LDL-C、HDL-C水平比较，差异均无统计学意义（P>0.05）;治疗后，试验组躯体健康、心理健康、社会功能评分均高于对照组（P<0.05），两组物质生活评分比较，差异无统计学意义（P>0.05）;试验组不良反应发生率低于对照组（P<0.05）。结论：阿立哌唑治疗慢性精神分裂症患者的临床疗效相比氯氮平更佳，且有利于改善患者的生活质量，减轻不良反应发生风险，且不会对患者脂质指标产生严重影响。

【关键词】 慢性精神分裂症; 阿立哌唑; 氯氮平; 脂质指标; 疗效

【Abstract】 Objective：To compare the effects of Aripiprazole and Clozapine on the efficacy and lipid indexes of patients with chronic schizophrenia.Method：A total of 72 patients with chronic schizophrenia admitted to our hospital from May 2016 to May 2017 were selected.According to the random lottery method，they were divided into experimental group and control group，36 cases in each group.The control group was treated with Clozapine and experimental group was treated with Aripiprazole.The clinical efficacy，lipid indexes（TG，TC，LDL-C，HDL-C）and quality of life before and after treatment，adverse reactions between two groups were compared.Result：The total effective rate was 97.22% in experimental group，which was higher than 83.33% in control group（P<0.05）.After treatment，the TG level in experimental group was lower than that of control group（P<0.05），the levels of TC，LDL-C and HDL-C in two groups were compared，the differences were not statistically significant（P>0.05）.After treatment，the scores of physical health，mental health and social function in experimental group were higher than those of control group（P<0.05），the material life scores of two groups were compared，the difference was not statistically significant（P>0.05）.The incidence of adverse reactions in experimental group was lower than that of control group（P<0.05）.Conclusion：Aripipiprazole has better clinical efficacy than Clozapine in treating chronic schizophrenia，and is beneficial to improving the quality of life of patients，reducing the risk of adverse reactions，and will not have a serious impact on patients lipid indexes.

【Key words】 Chronic schizophrenia; Aripiprazole; Clozapine; Lipid index; Curative effect

First-authors address：Zhiguang Mental Rehabilitation Hospital of Huazhou City，Huazhou 525100，China

doi：10.3969/j.issn.1674-4985.2019.16.039

慢性精神分裂癥是临床上十分常见的一种神经系统疾病，多见于青少年人群，患者主要临床表现涵盖思维、情感以及行为等多方面发生不同程度的障碍，可伴有精神活动的不协调[1]。其中认识功能受损是慢性精神分裂症患者最核心的症状，对患者的日常工作以及生活质量造成了极大的影响[2]。因此，予以慢性精神分裂症患者及时有效的治疗显得尤为重要。目前，临床上应用最为广泛的治疗慢性精神分裂症药物包括阿立哌唑以及氯氮平等，上述两种药物在慢性精神分裂症的治疗中均可获取明显的疗效[3]。然而，对于阿立哌唑与氯氮平的临床治疗效果优劣尚且存在一定的争议。且随着近年来临床上广泛应用非典型抗精神病药物，其对患者脂质代谢的影响开始备受关注，毕竟脂质代谢紊乱属于心脑血管疾病的生物学危险因素，脂质代谢紊乱势必会对患者的治疗依从性以及治疗效果造成不同程度的影响，甚至会增加患者家庭以及社会的经济负担[4]。……