目的 探讨不同剂量奥氮平治疗脑器质性和躯体疾病所致精神障碍患者的效果。方法 以收治的108例脑器质性和躯体疾病致精神障碍患者为研究对象，用随机数字表法分为对照组和观察组，每组54例。对照组予以大剂量奥氮平片治疗，观察组予以小剂量奥氮平片治疗。2组均治疗8周。比较2组治疗后的效果，治疗前后阳性与阴性症状量表(positive and negative symptom scale，PANSS)评分、神经功能缺损评分量表(national institute of health strokescale，NIHSS)评分、日常生活能力量表(activity of daily living，ADL)评分、简明精神病评定量表(brief psychiatric rating scale，BPRS)评分和糖脂代谢指标。结果 治疗后，观察组的临床总有效率高于对照组;2组阳性症状评分、阴性症状评分、一般精神病理评分、总评分、NIHSS评分及BPRS评分均降低，且观察组低于对照组(P＜0。05)，ADL评分升高，且观察组高于对照组(P＜0。05);2组血清总胆固醇(total cholesterol，TC)、低密度脂蛋白-胆固醇(low-density lipoprotein cholesterol，LDL-C)、三酰甘油(triglycerides，TG)、空腹血糖(fasting blood glucose，FBG)、空腹胰岛素(fasting insulin，FINS)、稳态胰岛素评价指数(homeostasis model assessment of insulin resistance，HOMA-IR)及餐后 2 h 血糖(2 hours postprandial blood glucose，2 h PBG)水平均升高，且观察组低于对照组，血清高密度脂蛋白-胆固醇(high-density lipopro-tein cholesterol，HDL-C)水平均降低，且观察组高于对照组(P＜0。05)。结论 脑器质性和躯体疾病所致精神障碍患者应用小剂量奥氮平能够有效提高其临床治疗效果及日常生活能力，改善其精神状况、临床症状及神经功能，同时对患者糖脂代谢的影响较小。
Effect of different doses of olanzapine on mental disorders caused by brain or-ganic and physical diseases
Objective To investigate the effect of different doses of olanzapine in patients with mental disorders caused by brain organic and physical diseases.Methods The subjects of this study were patients with mental disorders caused by brain organic and physical diseases.According to the random number table method,108 patients were divided into control group and observation group,54 cases in each group.The both groups were given Olanzapine Tablets,the control group was given a large dose,the observation group was given a small dose,and the both groups were treated for 8 weeks.The post-treatment effects,positive and negative symptom scale(PANSS),National Institute of Health Stroke Scale(NIHSS),activity of daily living(ADL),brief psychiatric rating scale(BPRS)scores,glucose and lipid metabolism indexes before and after treatment were compared between the 2 groups.Results After treat-ment,the total effective rate of observation group was higher than that of control group.After treatment,the scores of positive symp-toms,negative symptoms,general psychopathology,total score,NIHSS and BPRS in the 2 groups were lower than those before treat-ment,and the observation group was lower than the control group.The ADL score of the 2 groups increased,and the observation group was higher than the control group.Compared with before treatment,the serum levels of total cholesterol(TC),low-density li-poprotein cholesterol(LDL-C),triglycerides(TG),fasting blood glucose(FBG),fasting insulin(FINS),homeostasis model assess-ment of insulin resistance(HOMA-IR)and 2 hours postprandial blood glucose(2 h PBG)in the 2 groups increased after treatment,and the observation group was lower than the control group.The serum high-density lipoprotein cholesterol(HDL-C)level of the 2 groups decreased,and the observation group was higher than the control group,and the difference was statistically significant(P＜0.05).Conclusion The application of low dose olanzapine can effectively improve the clinical treatment effect and daily living ability of patients with mental disorders caused by brain organic and physical diseases,and improve their mental status,clinical symp-toms and neurological function.At the same time,it has relatively little effect on the internal glucose and lipid metabolism of patients.
olanzapinemental disorderbrain organicphysical diseasesneurological functionsugar and lipid metabolism
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