CAJ | 학술논문

目的：探讨齐拉西酮与氯氮平治疗精神分裂症的临床疗效以及对患者糖脂代谢和生活质量的影响。方法将72例精神分裂症患者随机分为两组，每组36例，观察组口服齐拉西酮治疗，对照组口服氯氮平治疗，观察12周。治疗前后采用阳性与阴性症状量表评定临床疗效，生活质量综合评定问卷评定生活质量，同时检测空腹血糖、胰岛素、低密度脂蛋白及体质量指数的变化。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（ P ＜0．01），同期两组间评分比较差异均无显著性（P＞0．05）。观察组治疗后生活质量综合评定问卷总分及躯体、心理、社会功能维度评分均较治疗前显著升高（P＜0．01），且显著高于对照组（P＜0．01）；对照组治疗后仅心理维度评分较治疗前显著升高（P ＜0．01）。观察组治疗后空腹血糖、胰岛素、低密度脂蛋白及体质量指数水平与治疗前比较差异均无显著性（P＞0．05），对照组均较治疗前显著升高（P＜0．05或0．01），观察组治疗后各项指标水平均显著低于对照组（P ＜0．05或0．01）。结论齐拉西酮与氯氮平治疗精神分裂症患者疗效相当，但齐拉西酮对患者糖脂代谢代谢影响较小，且能显著提高患者的生活质量。
목적：탐토제랍서동여록담평치료정신분렬증적림상료효이급대환자당지대사화생활질량적영향。방법장72례정신분렬증환자수궤분위량조，매조36례，관찰조구복제랍서동치료，대조조구복록담평치료，관찰12주。치료전후채용양성여음성증상량표평정림상료효，생활질량종합평정문권평정생활질량，동시검측공복혈당、이도소、저밀도지단백급체질량지수적변화。결과치료후량조양성여음성증상량표총분급각인자분균교치료전현저하강（ P ＜0．01），동기량조간평분비교차이균무현저성（P＞0．05）。관찰조치료후생활질량종합평정문권총분급구체、심리、사회공능유도평분균교치료전현저승고（P＜0．01），차현저고우대조조（P＜0．01）；대조조치료후부심리유도평분교치료전현저승고（P ＜0．01）。관찰조치료후공복혈당、이도소、저밀도지단백급체질량지수수평여치료전비교차이균무현저성（P＞0．05），대조조균교치료전현저승고（P＜0．05혹0．01），관찰조치료후각항지표수평균현저저우대조조（P ＜0．05혹0．01）。결론제랍서동여록담평치료정신분렬증환자료효상당，단제랍서동대환자당지대사대사영향교소，차능현저제고환자적생활질량。
Objective To explore the efficacy of ziprasidone and clozapine in schizophrenia and their influ‐ences on glucolipide metabolism and quality of life .Methods Seventy‐two schizophrenics were randomly divided into two groups of 36 ones each ,observation group took orally ziprasidone and control did clozapine for 12 weeks .Efficacies were assessed with Positive and Negative Syndrome Scale (PANSS) before and af‐ter treatment ,qualities of life with the Generic Quality of Life Inventory‐74 (GQOLI‐74) ,and the changes of blood‐fasting sugar (BFS) ,insulin ,low density lipoprotein (LDL) and body mass index (BMI) detected at the same time .Results After treatment the total and each factor scores of the PANSS of both groups lowered more significantly compared with pretreatment (P< 0 .01) ,there were no significant group differ‐ences (P> 0 .05) .The total ,physical ,psychological and social functioning score of the GQOLI‐74 height‐ened more significantly in observation group compared with pretreatment (P< 0 .01) and those were signif‐icantly higher than in control group (P< 0 .01) ;only psychological dimension score heightened more sig‐nificantly compared with pretreatment in control group (P < 0 .01) .There were no significant differences in BFS ,insulin ,LDL and BMI levels between post‐ and pre‐treatment in observation group (P > 0 .05) , those heightened more significantly after treatment compared with pretreatment in control group (P< 0 .05 or 0 .01) ,and those after treatment were significantly lower in observation than in control group (P< 0 .05 or 0 .01) .Conclusion Ziprasidone and clozapine have equivalent efficacy in schizophrenia ,but the former has less influence on glucolipide metabolism and could notably improve patients’ quality of life .