齐拉西酮和氟哌啶醇对首发精神分裂症患者的疗效及对认知功能和QTc间期的影响(1)
【摘要】 目的：分析齐拉西酮和氟哌啶醇对首发精神分裂症患者的疗效及对认知功能和QTc间期的影响。方法：选取2017年1月-2019年1月本院收治的108例首发精神病患者。按照随机数字表法将其分为观察组和对照组，各54例。对照组采用氟哌啶醇治疗，观察组采用齐拉西酮治疗，对比两组认知功能(MoCA评分)、治疗效果、阳性及阴性症状(PANSS评分)、QTc间期和不良反应。结果：治疗后，观察组MoCA评分、治疗总有效率均高于对照组，PANSS评分、不良反应发生率均低于对照组，差异均有统计学意义(P<0.05);观察组QTc间期波动大于对照组(P<0.05)。结论：齐拉西酮和氟哌啶醇对首发精神分裂症的治疗效果相当，均能有效改善患者的认知功能，且氟哌啶醇对患者QTc间期影响较小，而齐拉西酮的不良反应较少，安全性相对较高。
【关键词】 首发精神病 氟哌啶醇 齐拉西酮 QTc间期 认知功能
Effects of Ziprasidone and Haloperidol on Cognitive Function and QTc Interphase in Patients with First-episode Schizophrenia/CHEN Tao， XU Jinquan， WU Zhixiong， MA Yugui， HUANG Yan. //Medical Innovation of China， 2020， 17(09)： -140
[Abstract] Objective： To analyze the effect of Ziprasidone and Haloperidol on the first-episode of schizophrenia and the effect on cognitive function and QTc interphase. Method： From January 2017 to January 2019， 108 patients with first-episode of schizophrenia in our hospital were selected. According to the random number table method， they were divided into observation group and control group， 54 cases in each group. The control group was treated with Haloperidol and the observation group with Ziprasidone. The cognitive function (MoCA score)， therapeutic effect， positive and negative symptoms (PANSS score)， QTc interphase and adverse reactions were compared between the two groups. Result： After treatment， MoCA score and total effective rate of treatment in the observation group were higher than those in the control group， PANSS score and incidence of adverse reactions were lower than those in the control group， the differences were statistically significant (P<0.05). The QTc interphase fluctuation in the observation group was greater than that in the control group (P<0.05). Conclusion： Ziprasidone and Haloperidol have the same therapeutic effect on first-episode schizophrenia， both of them can effectively improve the cognitive function of patients， and Haloperidol has less effect on QTc interphase of patients， while Ziprasidone has less adverse reactions and higher safety.
[Key words] First-episode psychosis Haloperidol Ziprasidone QTc interphase Cognitive function
First-author’s address： Zhanjiang Third People’s Hospital， Zhanjiang 524000， China
doi：10.3969/j.issn.1674-4985.2020.09.034
精神病屬于慢性疾病，主要指因大脑功能失调引起的情感、认知和行为等多方面精神活动障碍，临床表现包括阳性症状、阴性症状和认知缺陷等[1]。首发精神病患者多存在性格变化、行为诡异和认知功能障碍等表现，严重影响患者身心健康和生活质量[2]。临床上，首发精神病患者多服用药物治疗，如氟哌啶醇是典型的抗精神病药物，可有效控制患者激越、兴奋等行为;齐拉西酮是非典型的抗精神病药物，可迅速缓解患者精神状况。两种药物各有优劣，治疗效果不一[3-4]。相关研究发现，QTc间期是反映患者心脏去极化和复极作用的重要指标[5]。精神病患者服用抗精神病药物后，可能延长QTc间期，从而诱发心律失常性猝死，对患者生命安全有一定危害。基于此，本文将分析齐拉西酮和氟哌啶醇对首发精神病患者的疗效及对认知功能和QTc间期的影响，现报道如下。, 百拇医药(陈涛 许锦泉 吴志雄 马玉桂 黄燕)
【关键词】 首发精神病 氟哌啶醇 齐拉西酮 QTc间期 认知功能
Effects of Ziprasidone and Haloperidol on Cognitive Function and QTc Interphase in Patients with First-episode Schizophrenia/CHEN Tao， XU Jinquan， WU Zhixiong， MA Yugui， HUANG Yan. //Medical Innovation of China， 2020， 17(09)： -140
[Abstract] Objective： To analyze the effect of Ziprasidone and Haloperidol on the first-episode of schizophrenia and the effect on cognitive function and QTc interphase. Method： From January 2017 to January 2019， 108 patients with first-episode of schizophrenia in our hospital were selected. According to the random number table method， they were divided into observation group and control group， 54 cases in each group. The control group was treated with Haloperidol and the observation group with Ziprasidone. The cognitive function (MoCA score)， therapeutic effect， positive and negative symptoms (PANSS score)， QTc interphase and adverse reactions were compared between the two groups. Result： After treatment， MoCA score and total effective rate of treatment in the observation group were higher than those in the control group， PANSS score and incidence of adverse reactions were lower than those in the control group， the differences were statistically significant (P<0.05). The QTc interphase fluctuation in the observation group was greater than that in the control group (P<0.05). Conclusion： Ziprasidone and Haloperidol have the same therapeutic effect on first-episode schizophrenia， both of them can effectively improve the cognitive function of patients， and Haloperidol has less effect on QTc interphase of patients， while Ziprasidone has less adverse reactions and higher safety.
[Key words] First-episode psychosis Haloperidol Ziprasidone QTc interphase Cognitive function
First-author’s address： Zhanjiang Third People’s Hospital， Zhanjiang 524000， China
doi：10.3969/j.issn.1674-4985.2020.09.034
精神病屬于慢性疾病，主要指因大脑功能失调引起的情感、认知和行为等多方面精神活动障碍，临床表现包括阳性症状、阴性症状和认知缺陷等[1]。首发精神病患者多存在性格变化、行为诡异和认知功能障碍等表现，严重影响患者身心健康和生活质量[2]。临床上，首发精神病患者多服用药物治疗，如氟哌啶醇是典型的抗精神病药物，可有效控制患者激越、兴奋等行为;齐拉西酮是非典型的抗精神病药物，可迅速缓解患者精神状况。两种药物各有优劣，治疗效果不一[3-4]。相关研究发现，QTc间期是反映患者心脏去极化和复极作用的重要指标[5]。精神病患者服用抗精神病药物后，可能延长QTc间期，从而诱发心律失常性猝死，对患者生命安全有一定危害。基于此，本文将分析齐拉西酮和氟哌啶醇对首发精神病患者的疗效及对认知功能和QTc间期的影响，现报道如下。, 百拇医药(陈涛 许锦泉 吴志雄 马玉桂 黄燕)
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