CAJ | 학술논문

目的比较奎硫平与利培酮治疗高龄老年人脑血管病所致精神障碍的疗效及安全性.方法 68例年龄≥75岁的脑血管病所致精神障碍的老年患者随机分为2组,分别服用奎硫平[(150±45)mg/d;32例]或利培酮[(1.8±0.8)mg/d;31例],疗程均为6周.采用阳性和阴性症状量表(PANSS)、临床疗效总评量表(CGI)及治疗中需处理的不良反应量表(TESS)于治疗前和治疗后第1,2,4,6周末分别评定疗效和副反应.结果 (1)奎硫平组的有效率为72%,利培酮组为71%,差异无统计学意义(X2=0.006,P>0.05);(2)2组治疗前后PANSS评分的差异均有统计学意义(配对t检验,P<0.05或<0.01);(3)奎硫平组PANSS总分减分率在治疗第1周末高于利培酮组(t:2.46,P<0.05),治疗第2,4,6周末的差异均无统计学意义(t2w=0.43,t4w=-0.73,t6w=-0.24,P均>0.05);(4)2组间EGI评分的差异无统计学意义(Z1w=0.57,Z2w=0.74,Z4w=0.68,Z6w=-0.61,P>0.05);(5)TESS评定,2组间的不良反应发生率的差异无统计学意义(四格表精确检验法,P>0.05).治疗期间利培酮组合用苯二氮革类药者多于奎硫平组,差异有统计学意义(X2=6.224,P<0.05).结论奎硫平和利培酮均对高龄老年人的脑血管病所致精神障碍有效,安全性较好.
목적 비교규류평여리배동치료고령노년인뇌혈관병소치정신장애적료효급안전성.방법 68례년령≥75세적뇌혈관병소치정신장애적노년환자수궤분위2조,분별복용규류평[(150±45)mg/d;32례]혹리배동[(1.8±0.8)mg/d;31례],료정균위6주.채용양성화음성증상량표(PANSS)、림상료효총평량표(CGI)급치료중수처리적불량반응량표(TESS)우치료전화치료후제1,2,4,6주말분별평정료효화부반응.결과 (1)규류평조적유효솔위72%,리배동조위71%,차이무통계학의의(X2=0.006,P>0.05);(2)2조치료전후PANSS평분적차이균유통계학의의(배대t검험,P<0.05혹<0.01);(3)규류평조PANSS총분감분솔재치료제1주말고우리배동조(t:2.46,P<0.05),치료제2,4,6주말적차이균무통계학의의(t2w=0.43,t4w=-0.73,t6w=-0.24,P균>0.05);(4)2조간EGI평분적차이무통계학의의(Z1w=0.57,Z2w=0.74,Z4w=0.68,Z6w=-0.61,P>0.05);(5)TESS평정,2조간적불량반응발생솔적차이무통계학의의(사격표정학검험법,P>0.05).치료기간리배동조합용분이담혁류약자다우규류평조,차이유통계학의의(X2=6.224,P<0.05).결론 규류평화리배동균대고령노년인적뇌혈관병소치정신장애유효,안전성교호.
Objective To compare the efficacy and side effects of quetiapine and risperidone in treatment of mental disorders due to vascular disease in the advanced elderly. Methods A total of 68 elderly with mental disorders due to vascular disease were randomly assigned to receive quetiapine or risperidone for 6 weeks. The Positive and Negative Syndrome Scale (PANSS),Clinical Global Impression (CGI-SI) and Treatment Emergent Symptom Scale (TESS) were adopted to evaluate the efficacy and side effects at baseline and after 1, 2, 4 and 6 week treatment. Results ( 1 ) After 6 week treatment, the response rate between the quetiapine and the risperidone groups was similar (72% vs. 71%, X2 =0. O06,P >0. 05). (2)The PANSS scores in both groups decreased significantly ( P < 0. 05 or P < 0. 01 ). (3) The decreasing radio of PANSS total score was significant higher in quefiapine group than in risperidone group after 1 week treatment (t=2.46, P < 0. 05 ), whereas no significant differences were found between the two groups from 2 to 6 week treatment (t2w =0. 43 ,t4w = -0. 73 ,t6w = -0. 24,all P >0. 05). (4)The CGI-SI score was not significantly different between groups from 1 week to 6 week treatment. (Z1w= 0. 57, Z2w = 0. 74, Z4w =0. 68,Z6w = 0. 61, all P > 0. 05). (5) The TESS showed the rate and severity of side effects did not differ between the two groups ( P > 0. 05 ). The co-medications for anxiety was significantly less frequent in quetiapine than risperidone group ( X2 = 6. 224, P < 0. 05). Conclusion Quetiapine and risperidone both provide valuable treatment options for the advanced elderly with mental disorders due to vascular disease.