奥氮平与帕利哌酮对首发精神分裂症患者血清叶酸、同型半胱氨酸和脑源性神经营养因子水平的影响
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摘要
目的探析奥氮平与帕利哌酮对首次发病精神分裂症患者血清叶酸、同型半胱氨酸和脑源性神经营养因子水平的影响。方法选取我院2016年9月～2017年9月收治的100例首次发病精神分裂症患者为观察组,另选同期100例健康体检者为对照组,对两组血清叶酸、同型半胱氨酸和脑源性神经营养因子进行对比,随后采用掷硬币法将观察组分为接受帕利哌酮治疗的帕利哌酮组及接受奥氮平治疗的奥氮平组两个亚组各50例,对两亚组治疗前后指标变化进行对比。结果观察组血清叶酸、脑源性神经营养因子低于对照组,同型半胱氨酸高于对照组,差异有统计学意义(P<0.05);观察组内两亚组治疗前血清叶酸、同型半胱氨酸和脑源性神经营养因子水平无明显差异,治疗2周、治疗4周、治疗6周、治疗8周各指标数值相比较,奥氮平组血清叶酸、脑源性神经营养因子水平低于帕利哌酮组,而同型半胱氨酸高于帕利哌酮组但组间差异无统计学意义(P>0.05);疗程结束后两组患者不良反应发生率比较,奥氮平组略高于帕利哌酮组但差异无统计学意义(P>0.05)。结论相较于临床常规用药的帕利哌酮,奥氮平对首次发病精神分裂症患者血清叶酸、同型半胱氨酸和脑源性神经营养因子水平的影响略逊于后者但差异并不明显,在患者存在帕利哌酮用药禁忌时可选取奥氮平予以替代治疗。
Objective To investigate the effects of olanzapine and paliperidone on serum folic acid,homocysteine and brain-derived neurotrophic factor levels in patients with first-episode schizophrenia. Methods 100 patients with schizophrenia who first developed in our hospital from September 2016 to September 2017 were selected as observation group,and 100 healthy people in the same period were selected as control group. Serum folic acid,homocysteine and brain-derived neurotrophic factors were compared between the two groups. Then the observation group was divided into paliperidone group receiving paliperidone and ozone group receiving OLAM by coin tossing method. In the olanzapine group,there were 50 cases in each of the two subgroups. The changes of the indexes before and after treatment were compared between the two subgroups. Results Serum folic acid and brain-derived neurotrophic factor in the observation group were lower than those in the control group,and homocysteine was higher than those in the control group(P<0.05). There was no significant difference in serum folic acid,homocysteine and brain-derived neurotrophic factor levels between the two subgroups before treatment in the observation group. The levels of serum folic acid and brainderived neurotrophic factors in azapine group were lower than those in paliperidone group,while homocysteine was higher than that in paliperidone group,but there was no significant difference between the two groups(P>0.05);after the end of treatment,the incidence of adverse reactions in olanzapine group was slightly higher than that in paliperidone group,but there was no significant difference(P> 0.05). Conclusions Compared to paliperidone used clinically,olanzapine has slightly lesser effects on serum folic acid,homocysteine,and brain-derived neurotrophic factor levels in patients with first-episode schizophrenia but differs significantly from the latter. Obviously,olanzapine can be used as an alternative treatment when patients have contraindications to the use of paliperidone.
Objective To investigate the effects of olanzapine and paliperidone on serum folic acid,homocysteine and brain-derived neurotrophic factor levels in patients with first-episode schizophrenia. Methods 100 patients with schizophrenia who first developed in our hospital from September 2016 to September 2017 were selected as observation group,and 100 healthy people in the same period were selected as control group. Serum folic acid,homocysteine and brain-derived neurotrophic factors were compared between the two groups. Then the observation group was divided into paliperidone group receiving paliperidone and ozone group receiving OLAM by coin tossing method. In the olanzapine group,there were 50 cases in each of the two subgroups. The changes of the indexes before and after treatment were compared between the two subgroups. Results Serum folic acid and brain-derived neurotrophic factor in the observation group were lower than those in the control group,and homocysteine was higher than those in the control group(P<0.05). There was no significant difference in serum folic acid,homocysteine and brain-derived neurotrophic factor levels between the two subgroups before treatment in the observation group. The levels of serum folic acid and brainderived neurotrophic factors in azapine group were lower than those in paliperidone group,while homocysteine was higher than that in paliperidone group,but there was no significant difference between the two groups(P>0.05);after the end of treatment,the incidence of adverse reactions in olanzapine group was slightly higher than that in paliperidone group,but there was no significant difference(P> 0.05). Conclusions Compared to paliperidone used clinically,olanzapine has slightly lesser effects on serum folic acid,homocysteine,and brain-derived neurotrophic factor levels in patients with first-episode schizophrenia but differs significantly from the latter. Obviously,olanzapine can be used as an alternative treatment when patients have contraindications to the use of paliperidone.
引文
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5.胡乃启,张朋,宋宁,等.利培酮联合奥氮平对首发精神分裂症患者血清同型半胱氨酸水平和认知功能及临床疗效的影响[J].河北医学,2016,22(11):1837-1839.
6.程伟.奥氮平联合无抽搐电休克治疗对精神分裂症患者细胞因子、sTNFRs及神经电生理特征的影响[J].海南医学院学报,2016,22(23):2893-2896.
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8.Liu C,Xue ZM,Pu WD.Probe into Abnormality of Brain Gray Matter Volumes in Schizophrenia Patients and Their Healthy Siblings[J].Med One,2016,1(3):4.
9.崔力军,潘鑫,朱洁琳,等.帕利哌酮与奥氮平治疗首发精神分裂症患者的疗效观察[J].中国临床药理学与治疗学,2017,22(04):466-470.
10.李彪,迟正锁,陈贝,等.氨磺必利、帕利哌酮缓释片、奥氮平对首发未用药精神分裂症患者认知、记忆功能的影响[J].国际精神病学杂志,2015,42(05):14-17.
2.鲍成,郭街仔,龚发金,等.奥氮平、利培酮、齐拉西酮对首发精神分裂症患者心脏代谢的影响[J].实用中西医结合临床,2017,17(07):7-9.
3.Jiang SZ,Yan K,Fu YH,et al.The Correlation between Plasma Concentration of Aripiprazole and Clinical Efficacy in the Treatment of Children and Adolescent Patients with Schizophrenia[J].Journal of Psychiatry and Brain Science,2017,2(6):4.
4.李四冬,阳前军,熊华朝,等.帕利哌酮与奥氮平对精神分裂症首发女性患者疗效及代谢、体质量的影响[J].国际精神病学杂志,2015,42(03):3-6.
5.胡乃启,张朋,宋宁,等.利培酮联合奥氮平对首发精神分裂症患者血清同型半胱氨酸水平和认知功能及临床疗效的影响[J].河北医学,2016,22(11):1837-1839.
6.程伟.奥氮平联合无抽搐电休克治疗对精神分裂症患者细胞因子、sTNFRs及神经电生理特征的影响[J].海南医学院学报,2016,22(23):2893-2896.
7.梁静,董玉霞,孟祥军.奥氮平对首次发病精神分裂症患者血清叶酸、同型半胱氨酸和脑源性神经营养因子水平的影响[J].临床精神医学杂志,2016,26(04):266-267.
8.Liu C,Xue ZM,Pu WD.Probe into Abnormality of Brain Gray Matter Volumes in Schizophrenia Patients and Their Healthy Siblings[J].Med One,2016,1(3):4.
9.崔力军,潘鑫,朱洁琳,等.帕利哌酮与奥氮平治疗首发精神分裂症患者的疗效观察[J].中国临床药理学与治疗学,2017,22(04):466-470.
10.李彪,迟正锁,陈贝,等.氨磺必利、帕利哌酮缓释片、奥氮平对首发未用药精神分裂症患者认知、记忆功能的影响[J].国际精神病学杂志,2015,42(05):14-17.