目的 探讨药物基因组学检测结果应用对难治性精神分裂症患者疗效及药物不良反应的影响。方法 选取 2020 年 1月—2022 年 6 月江苏省淮安市第三人民医院收治的 100 例难治性精神分裂症患者。依据基因检测结果指导用药，分别于治疗前、治疗 4、8、12、16 周使用阳性阴性症状量表(positive and egative symptom scale，PANSS)、临床疗效总评量表(clinical global impression，CGI)评定临床疗效，威斯康星卡片分类测验及个人和社会功能评估量表(personal and social function assessment scales，PSP)分别评定认知及社会功能改善情况，同时使用药物副反应量表(treatment emergent symptom scale，TESS)及做血常规、肝功能、肾功能和心电图等检查，以了解药物不良反应。结果治疗 4 周PANSS评分为(59。62±6。29)分，治疗 8 周PANSS评分为(54。83±7。37)分，治疗12周PANSS评分为(49。34±7。93)分，治疗 16 周PANSS评分(44。68±8。73)分，均低于治疗前的(62。93±5。55)分(P＜0。001);治疗 4、8、12 和 16 周的CGI、PSP、威斯康星卡片分类测验等评分均优于治疗前(P＜0。001)。治疗 16 周TESS评定与治疗 4 周比较，差异有统计学意义(P＜0。01)，但血常规、心电图、脑电图、肝功能和肾功能检查异常与否与治疗前比较，差异无统计学意义(P＞0。05)。结论 应用基因检测可显著提高难治性精神分裂症患者的临床疗效，且并不增加不良反应，因此基因检测可促进该病的临床合理用药、精准用药和个体化治疗。
The Impact of Drug Gene Testing on the Treatment Prognosis of Refractory Schizophrenia Patients
Objective To explore the effects of pharmacogenomic testing results on the prognosis and adverse drug reactions in patients with refractory schizophrenia.Methods A total of 100 patients with refractory schizophrenia admitted to Huai'an NO.3 People's Hospital,Jiangsu Province from January 2020 to June 2022 were selected.According to the genetic test results,positive and egative symptom scale(PANSS)and clinical global impression(CGI)were used to evaluate the clinical efficacy before treatment,and at 4,8,12 and 16 weeks of treatment,respectively.Wisconsin card sorting test and personal and social function assessment scales(PSP)were used to evaluate the improvement of cognitive and social function,respectively.Treatment emergent symptom scale(TESS)and blood routine,liver function,kidney function and electrocardiogram were used to understand the adverse drug reactions.Results The PANSS score was(59.62±6.29)points after 4 weeks of treatment,(54.83±7.37)points after 8 weeks of treatment,(49.34±7.93)points after 12 weeks of treatment,and(44.68±8.73)points after 16 weeks of treatment.All of them were lower than that before treatment(62.93±5.55)points(P<0.001).The scores of CGI,PSP and Wisconsin card sorting test at 4,8,12 and 16 weeks of treatment were better than those before treatment(P<0.001).There was statistical significance in TESS assessment after 16 weeks of treatment compared with 4 weeks of treatment(P<0.01),but there was no statistical significance in abnormal blood routine,electrocardiogram,electroencephalogram,liver function and kidney function compared with before treatment(P>0.05).Conclusion The application of gene detection can significantly improve the clinical effect of drug therapy in refractory schizophrenic patients,and it does not significantly increase the adverse reactions,therefore,genetic testing can promote the rational clinical drug use,precision drug use and individualized drug treatment.
gene detectionrefractory schizophreniaclinical effectsthe side effects of drugsrational drug useprecision drug use
万方数据
维普
