首页|齐拉西酮和帕利哌酮联合无抽搐电休克疗法对双相情感障碍患者症状、糖脂代谢及激素水平的影响

齐拉西酮和帕利哌酮联合无抽搐电休克疗法对双相情感障碍患者症状、糖脂代谢及激素水平的影响

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目的:探讨齐拉西酮和帕利哌酮联合无抽搐电休克疗法(MECT)对双相情感障碍患者症状、糖脂代谢及激素水平的影响.方法:纳入 2021 年 1 月—2023 年 8 月江西省精神病院收治的 82 例双相情感障碍患者,遵循随机数字表将其分为齐拉西酮组(n=41)及帕利哌酮组(n=41).齐拉西酮组提供齐拉西酮+MECT治疗,帕利哌酮组提供帕利哌酮+MECT治疗.比较两组治疗前后的狂躁症状[贝克-拉范森躁狂量表(BRMS)]、精神状态[阳性和阴性精神症状评定量表(PANSS)]、双相情感障碍严重程度[临床总体印象疾病严重度量表-双相情感障碍版(CGI-BP)]、糖脂代谢水平[总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)]、激素水平[皮质醇(Cor)、促肾上腺皮质激素(ACTH)、三碘甲状腺原氨酸(T3)]及治疗期间的不良反应.结果:治疗后,两组BRMS评分,PANSS中阳性症状、阴性症状、一般精神病理评分,CGI-BP评分及Cor,ACTH水平均较治疗前降低(P<0.05),且齐拉西酮组均低于帕利哌酮组(P<0.05).治疗后,两组TC、TG水平均较治疗前升高(P<0.05),两组TC、TG比较,差异均无统计学意义(P>0.05).治疗前后,两组T3、FPG水平比较,差异均无统计学意义(P>0.05).两组不良反应发生率(12.20%vs 19.51%)比较,差异无统计学意义(P>0.05).结论:齐拉西酮+MECT治疗可减轻双相情感障碍患者躁狂症状,促进精神状态好转,稳定糖脂代谢和激素水平,且不良反应低.
Influence of Ziprasidone and Paliperidone Combined with Modified Electroconvulsive Therapy on Symptoms,Glucolipid Metabolism and Hormones Levels in Patients with Bipolar Disorder
Objective:To explore the influence of combined therapy with Ziprasidone,Paliperidone and modified electroconvulsive therapy(MECT)on symptoms,glucolipid metabolism and hormones in patients with bipolar disorder.Method:A total of 82 patients with bipolar disorder admitted between January 2021 and August 2023 in Jiangxi Mental Hospital were enrolled and divided into Ziprasidone group(41 cases)and Paliperidone group(41 cases)according to the random number table method.The Ziprasidone group was treated with Ziprasidone+MECT,while the Paliperidone group was given Paliperidone+MECT.The two groups were compared in terms of mania symptoms[Beck-Rafaelson mania scale(BRMS)],mental state[positive and negative syndrome scale(PANSS)],severity of bipolar disorder[clinical global impression scale for bipolar disorder(CGI-BP)],glucolipid metabolism[total cholesterol(TC),triglyceride(TG),fasting plasma glucose(FPG)]and hormones[cortisol(Cor),adrenocorticotropic hormone(ACTH),triiodothyronine(T3)]before and after treatment and adverse reactions during treatment.Result:After treatment,the BRMS score,scores of positive symptom,negative symptom and general psychopathology of PANSS,CGI-BP score and levels of Cor and ACTH were decreased in both groups compared to those before treatment(P<0.05),and those in the Ziprasidone group were lower than those in the Paliperidone group(P<0.05).After treatment,the levels of TC and TG in the two groups were increased compared to those before treatment(P<0.05),there were no statistical differences in TC and TG between the two groups(P>0.05).Before and after treatment,there were no statistical differences in T3 and FPG levels between the two groups(P>0.05).There was no obvious difference in adverse reaction between the two groups(12.20%vs 19.51%)(P>0.05).Conclusion:Ziprasidone+MECT for patients with bipolar disorder can relieve the mania symptoms,promote the improvement of mental state,and stabilize the glucolipid metabolism and hormones levels,and it has low adverse reactions.

ZiprasidonePaliperidoneModified electroconvulsive therapyBipolar disorderGlucolipid metabolismHormones

王炎

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江西省精神病院精神科 江西 南昌 330000

齐拉西酮 帕利哌酮 无抽搐电休克疗法 双相情感障碍 糖脂代谢 激素

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(24)