利培酮单用与合并乙酰半胱氨酸治疗精神分裂症首次发病患者的对照研究

摘要

Objective:To explore the influence of N-acetly-cysteine on the add-on curative efficacy and lipid metabolism of schizophrenia patients at the first episode who are treated with risperidone. Method:One hundred and twenty-one schizophrenic patients were randomly divided into study group(61 cases)and control group(60 cases). Based on the risperidone therapy,N-acetly-cysteine and placebo were added on the study group and control group respectively and observed for 8 weeks. Before and after 8 weeks of treatment,the treat-ment effect was assessed by positive and negative symptoms scale( PANSS)and meanwhile serum levels of tri-glyceride( TG),total cholesterol( TC),and low density lipid( LDL)were measured. Then,the result of before-and-after treatment on the two groups was compared. Results:After 4 and 8 weeks,total and each factor score of PANSS in the two groups decreased significantly(t=32. 16~93. 19,all P<0. 05). The negative symptoms factor score in the study group was lower than the control group(t=8. 40;P<0. 05). The body weight in the two groups increased significantly after 4 and 8 weeks treatment( study group:t= -5. 62,t= -6. 19;control group:t= -6. 20,t= -6. 32;all P<0. 05)without group difference(P>0. 05). TG,LDL,TC in the study group were significantly lower than in the control group(t=3. 97~13. 51,all P<0. 05). Conclusion:Only risperidone or N-acetly-cysteine add-on therapy can improve mental symptoms in schizophrenic patients and re-duce serum TG,LDL and TC,but no effect on body weight gain.%目的：探讨乙酰半胱氨酸（ NAC）对利培酮治疗首发精神分裂症患者的辅助疗效以及对血脂代谢的影响。方法：采用随机双盲法将121例首次发病精神分裂症患者随机分为研究组61例和对照组60例，两组在利培酮治疗的基础上分别联合NAC和安慰剂，观察8周。于治疗前及治疗4周和8周时采用阳性和阴性症状量表（ PANSS）评定疗效；同时检测体质量、血清总胆固醇（ TC）、三酰甘油（ TG）、低密度脂蛋白（ LDL）水平，并对两组治疗前后变化进行比较。结果：治疗4周和8周后两组PANSS总分及各因子分均较治疗前明显降低（ t=32.16~93.19，P均＜0.05）；两组间比较，研究组（尤其阴性症状因子分）显著低于对照组（ t=8.40；P＜0.05）。两组体质量治疗后均较治疗前显著升高（研究组：t=-5.62，t=-6.19；对照组：t=-6.20，t=-6.32），治疗前后比较，差异有统计学意义（ P均＜0.05）；两组间比较，差异无统计学意义（P＞0.05）。治疗后研究组TG、LDL、TC水平显著低于对照组，差异有统计学意义（ t=3.97~13.51，P均＜0.05）。结论：利培酮单用或辅助NAC治疗可明显改善首发精神分裂症患者的精神症状；同时降低血TG、LDL、TC水平，但对体质量增加无影响。