摘要
目的:探讨长期服用抗精神分裂症药对患者肾功能的影响。方法:回顾性选取2014年3月至2018年4月海南省安宁医院收治的精神分裂症患者180例的临床资料,根据治疗方式的不同将患者分为氯丙嗪组(采用氯丙嗪治疗)、奥氮平组(采用奥氮平片治疗)和利培酮组(采用利培酮片治疗),每组60例。观察三组患者的临床疗效、肾功能指标[肌酐(Scr)、尿素氮(BUN)、尿酸(UA)及尿微量白蛋白排泄率(uAE)]、阳性和阴性症状量表(positive and negative syndrome scale,PANSS)评分及治疗期间不良反应发生情况。结果:治疗12个月后,氯丙嗪组、奥氮平组和利培酮组患者的总有效率分别为80.00%(48/60)、90.00%(54/60)和86.67%(52/60),差异无统计学意义(P>0.05)。治疗3、12个月后,三组患者血清Scr、BUN、UA及uAE水平较治疗前明显升高,差异均有统计学意义(P<0.05);但三组患者同期血清Scr、BUN、UA及uAE水平组间比较的差异均无统计学意义(P>0.05)。与治疗前相比,氯丙嗪组患者治疗3、12个月后的PANSS评分呈先降低后升高趋势,差异均有统计学意义(P<0.05);治疗3、12个月后,奥氮平组、利培酮组患者PANSS评分呈持续降低趋势,与同组治疗前相比的差异均有统计学意义(P<0.05);治疗3、12个月后,奥氮平组、利培酮组患者PANSS评分明显低于氯丙嗪组,差异均有统计学意义(P<0.05)。治疗期间,奥氮平组、利培酮组患者的不良反应发生率明显低于氯丙嗪组,差异均有统计学意义(P<0.05);但奥氮平组、利培酮组患者不良反应发生率组间比较的差异无统计学意义(P>0.05)。结论:氯丙嗪、奥氮平及利培酮治疗精神分裂症,均可有效改善患者的临床症状,疗效确切,其中奥氮平、利培酮改善临床症状更明显及不良反应发生率更低;但长期服用可对患者肾功能造成一定影响,在患者治疗精神分裂症期间应定期监测肾功能。
OBJECTIVE:To probe into the effects of long-term application of antischizophrenic drugs on renal function of patients.METHODS:Totally 180 patients with schizophrenia admitted to Hainan Provincial Anning Hospital from Mar.2014 to Apr.2018 were retrospectively selected to be divided into the chlorpromazine group(treated with chlorpromazine),olanzapine group(treated with olanzapine tablets)and risperidone group(treated with risperidone tablets)according to different treatment methods,with 60 cases in each group.The clinical efficacy,renal function index[serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA)and uric albumin excretion(uAE)],positive and negative symptom scale(PANSS)and incidence of adverse drug reactions of three groups were observed.RESULTS:After treatment of 12 months,the total effective rates of the chlorpromazine group,the olanzapine group and the risperidone group were 80.00%(48/60),90.00%(54/60),and 86.67%(52/60),respectively,the difference was not statistically significant(P>0.05).After treatment of 3 and 12 months,the serum levels of Scr,BUN,UA and uAE in three groups were significantly higher than those before treatment,with statistically significant differences(P<0.05).Yet there were no statistically significant differences in serum levels of Scr,BUN,UA and uAE among three groups(P>0.05).Compared with before treatment,the PANSS score of patients in the chlorpromazine group showed the decreasing trend of first and then increasing after treatment of 3 and 12 months,and the differences were statistically significant(P<0.05).After treatment of 3 and 12 months,the PANSS score in the olanzapine group and the risperidone group showed the continuous decreasing trend,and the differences were statistically significant compared with those before treatment in the same group(P<0.05).After treatment of 3 and 12 months,the PANSS score in the olanzapine group and the risperidone group were significantly lower than those in the chlorpromazine group,with statistically significant differences(P<0.05).Dur
作者
韩妙林
李佳
HAN Miaolin;LI Jia(Psychological Counseling Center, Hainan Provincial Anning Hospital, Hainan Haikou 571101, China;Dept. of Psychology, Hainan General Hospital, Hainan Haikou 571101, China)
出处
《中国医院用药评价与分析》
2020年第5期543-546,550,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
海南省社会发展科技专项项目(No.SF2014103)。
关键词
长期
氯丙嗪
奥氮平
利培酮
肾功能
Long-term
Chlorpromazine
Olanzapine
Risperidone
Renal function
