奥氮平与利培酮治疗系统性红斑狼疮所致精神障碍疗效对照分析(1)
【摘要】 目的：探讨奥氮平与利培酮治疗系统性红斑狼疮所致精神障碍的疗效及安全性。方法：将64例红斑狼疮所致精神障碍患者随机分为两组，分别予奥氮平及利培酮治疗4周，在治疗前及治疗后1、2、3、4周分别予PANSS量表评定疗效，用TESS量表评定不良反应。结果：治疗1周后奥氮平组患者PANSS评分开始下降，较利培酮组起效快，两组患者疗效比较差异有统计学意义(P<0.01)；奥氮平组不良反应也低于利培酮组，差异有统计学意义(P<0.01)。结论：奥氮平与利培酮对红斑狼疮所致精神障碍均有效，而奥氮平起效更快，不良反应较少，更适合红斑狼疮所致精神障碍患者。
【关键词】 系统性红斑狼疮； 精神障碍； 奥氮平； 利培酮
Effect Comparative Analysis of Olanzapine and Risperidone in the Treatment of Mental Disorder Caused by Systemic Lupus Erythematosus/YE Qing-hong， CHEN Zhi-bin， TANG Kai，et al.//Medical Innovation of China，2015，12(36)：030-032
, http://www.100md.com
【Abstract】 Objective：To investigate the efficacy and safety of Olanzapine and Risperidone on mental disorder caused by lupus erythema. Method： 64 patients with mental disorders due to systemic lupus erythematosus were divided into two groups，they were treated with Olanzapine and Risperidone for 4 weeks.The efficacy before treatment and after treatment 1week， 2， 3， 4 weeks were evaluated by PANSS scale，the adverse reactions were evaluated by TESS scale. Result：After treatment for 1 week，PANSS scores of the Olanzapine group were dropped significantly，the effect was faster than the Risperidone group，the curative effect difference of the two groups was statistically significant (P<0.01). The adverse reactions of the Olanzapine group were lower than those of the Risperidone group， the differences were statistically significant (P<0.01).Conclusion： Olanzapine and Risperidone on mental disorders caused by lupus erythematosus are effective， and Olanzapine work faster， with less adverse reaction， more suitable for patients with mental disorder caused by lupus erythematosus.
, 百拇医药
【Key words】 Systemic lupus erythematosus； Mental disorder； Olanzapine； Risperidone
First-author’s address：Guilin Social Welfare Hospital(Guilin City Mental Health Center)，Guilin 541001，China
doi：10.3969/j.issn.1674-4985.2015.36.010
系统性红斑狼疮(SLE)是一种严重的慢性全身性自身免疫性疾病，临床上有典型蝶形或盘状红斑皮肤损害，并可以累及多种脏器，主要临床特征为大量自身抗体产生和多脏器损害。系统性红斑狼疮在我国发病率约为0.4%～0.8%，好发于青年女性，其中育龄期女性占90%～95%，15～40岁为发病高峰年龄段，蝶形红斑和脱发影响容貌，而疾病引发的心肾功能不全不适合妊娠，影响其自我评价和婚姻家庭生活[1]；男女发病比例约为1∶9，其中儿童和老年患者男女发病比例约为1∶2，最近的流行病学调查资料显示全球患病率为(20～50)/10万[2]，我国患病率约为70/10万[3]。SLE如出现中枢神经系统受损， 即可诊断神经精神狼疮(NPSLE)， 发生率达14%～75%，是SLE病情危重的临床先兆，也是狼疮危象的主要死亡原因之一，影像学显示脑实质损害，并排除其他疾病，便可诊断，可表现为精神症状、癫痫等症状[4]。狼疮脑病的发病机制有以下几种假说：(1)免疫复合物沉积性血管炎；(2)抗神经原抗体及脑组蛋白(BIMP)抗体；(3)抗心磷脂抗体直接作用于血管内皮细胞和血小板的磷脂成分；(4)抗核糖体P蛋白抗体；(5)低蛋白血症；(6)细胞因子致病[5-10]。精神症状表现为精神病样反应，如妄想视听幻觉木僵恐惧被控制感[11]。本研究用奥氮平治疗红斑狼疮所致精神障碍，疗效确切，现报道如下。
1 资料与方法, http://www.100md.com(叶庆红 陈志斌 唐锴 杨敏 张东平)
【关键词】 系统性红斑狼疮； 精神障碍； 奥氮平； 利培酮
Effect Comparative Analysis of Olanzapine and Risperidone in the Treatment of Mental Disorder Caused by Systemic Lupus Erythematosus/YE Qing-hong， CHEN Zhi-bin， TANG Kai，et al.//Medical Innovation of China，2015，12(36)：030-032
, http://www.100md.com
【Abstract】 Objective：To investigate the efficacy and safety of Olanzapine and Risperidone on mental disorder caused by lupus erythema. Method： 64 patients with mental disorders due to systemic lupus erythematosus were divided into two groups，they were treated with Olanzapine and Risperidone for 4 weeks.The efficacy before treatment and after treatment 1week， 2， 3， 4 weeks were evaluated by PANSS scale，the adverse reactions were evaluated by TESS scale. Result：After treatment for 1 week，PANSS scores of the Olanzapine group were dropped significantly，the effect was faster than the Risperidone group，the curative effect difference of the two groups was statistically significant (P<0.01). The adverse reactions of the Olanzapine group were lower than those of the Risperidone group， the differences were statistically significant (P<0.01).Conclusion： Olanzapine and Risperidone on mental disorders caused by lupus erythematosus are effective， and Olanzapine work faster， with less adverse reaction， more suitable for patients with mental disorder caused by lupus erythematosus.
, 百拇医药
【Key words】 Systemic lupus erythematosus； Mental disorder； Olanzapine； Risperidone
First-author’s address：Guilin Social Welfare Hospital(Guilin City Mental Health Center)，Guilin 541001，China
doi：10.3969/j.issn.1674-4985.2015.36.010
系统性红斑狼疮(SLE)是一种严重的慢性全身性自身免疫性疾病，临床上有典型蝶形或盘状红斑皮肤损害，并可以累及多种脏器，主要临床特征为大量自身抗体产生和多脏器损害。系统性红斑狼疮在我国发病率约为0.4%～0.8%，好发于青年女性，其中育龄期女性占90%～95%，15～40岁为发病高峰年龄段，蝶形红斑和脱发影响容貌，而疾病引发的心肾功能不全不适合妊娠，影响其自我评价和婚姻家庭生活[1]；男女发病比例约为1∶9，其中儿童和老年患者男女发病比例约为1∶2，最近的流行病学调查资料显示全球患病率为(20～50)/10万[2]，我国患病率约为70/10万[3]。SLE如出现中枢神经系统受损， 即可诊断神经精神狼疮(NPSLE)， 发生率达14%～75%，是SLE病情危重的临床先兆，也是狼疮危象的主要死亡原因之一，影像学显示脑实质损害，并排除其他疾病，便可诊断，可表现为精神症状、癫痫等症状[4]。狼疮脑病的发病机制有以下几种假说：(1)免疫复合物沉积性血管炎；(2)抗神经原抗体及脑组蛋白(BIMP)抗体；(3)抗心磷脂抗体直接作用于血管内皮细胞和血小板的磷脂成分；(4)抗核糖体P蛋白抗体；(5)低蛋白血症；(6)细胞因子致病[5-10]。精神症状表现为精神病样反应，如妄想视听幻觉木僵恐惧被控制感[11]。本研究用奥氮平治疗红斑狼疮所致精神障碍，疗效确切，现报道如下。
1 资料与方法, http://www.100md.com(叶庆红 陈志斌 唐锴 杨敏 张东平)