利培酮口服液与奥氮平治疗老年人脑血管病所致精神障碍的疗效及安全性

摘要

目的：比较利培酮口服液与奥氮平治疗老年人脑血管病所致精神障碍的疗效及安全性。方法：把67例年龄≥60岁的脑血管病所致精神障碍的老年患者分为两组,分别给予服用利培酮口服液(1.9依0.78)ml/d或奥氮平(6.75依2.65)mg/d,疗程为4周。采用简明精神病评定量表(BPRS)、临床疗效总评量表(CGI)及不良反应量表(TESS)于治疗前和治疗后第1、2、4周末分别评定疗效和不良反应。结果：(1)利培酮口服液组患者的治疗有效率为76.4%,奥氮平组患者的治疗有效率为75.7%,差异无统计学意义(x2=0.006,P>0.05)；(2)两组治疗前后BPRS评分的差异均有统计学意义(配对t检验,P<0.05)；(3)两组间CGI评分的差异无统计学意义(Z1周=0.57,Z2周=0.75,Z4周=0.67, P>0.05)；(4)TESS评定,两组间患者治疗的不良反应发生率的差异无统计学意义。治疗期间利培酮口服液组与奥氮平组患者治疗合用盐酸苯海索,差异无统计学意义(x2=3.608,P>0.05)；利培酮口服液合用苯二氮类药者多于奥氮平组,差异有统计学意义(x2=6.788,P<0.05)。结论：利培酮口服液和奥氮平对老年人脑血管病所致精神障碍有效,安全性较好。%Objective:To compare efficacy and safety of risperidone oral solution and olanzapine in treatment of mental disor-ders due to cerebrovascular disease in the elderly. Methods:A total of 67 cases (≥60 years old) with mental disorders due to cerebro-vascular disease were divided into risperidone oral solution group [34 cases, (1. 9±0. 78) ml/d, 4 weeks] and olanzapine [33 cases, (6. 75±2. 65) ml/d, 4 weeks]. Brief psychiatric rating scale (BPRS), clinical global impression (CGI-SI) and treatment emergent symptom scale (TESS) were adopted to evaluate the efficacy and side effects at base line and 1, 2 and 4 weeks after the treatment. Re-sults:(1) After 4 weeks' treatment, the response rate between risperidone oral solution group and olanzapine group was statistically in-significant (76. 4% vs 75. 7%, x2=0. 006, P>0. 05). (2) The BPRS scores of the two groups before and after the treatment both had the statistical significance (paired T test, P<0. 05). (3) The CGI-SI score was not significantly different between the two groups 1, 2, and 4 weeks after the treatment. (Z1w=0. 57, Z2w=0. 75, Z4w=0. 67, all P>0. 05). (4) The TESS showed the rate and severi-ty of side effects did not differ between the two groups (P>0. 05). The co-medications for extrapyramidal symptoms (EPS) was no significantly different between the two groups (x2=3. 608, P>0. 05). The co-medications for anxiety was significantly less frequent in olanzapine group than that in risperidone oral solution group(x2 =6. 788, P<0. 05). Conclusions: Risperidone oral solution and olanzapine are both effective and safe for the elderly with mental disorders due to cerebrovascular disease.