【摘要】 目的了解奥氮平长期治疗首发精神分裂症的疗效、不良反应等。方法采用自然观察研究方法,结合全病程管理模式对研究对象进行1年随访观察。136例符合国际疾病分类第十次修订本(ICD-10)精神分裂症或分裂样精神障碍研究用诊断标准的首发患者纳入研究,给予可变剂量的奥氮平治疗。采用阳性和阴性症状量表(PANSS)评估疗效,副反应量表(TESS)评估治疗的不良反应。PANSS减分率≥50%为有效。结果治疗第2个月末有效率为50%(65/129),第3、6、8、12个月末的有效率分别为57%(71/125)、63%(70/69)、71%(73/103)、75%(70/93)。101例治疗有效的患者中随访期间有17例复发。1年末43例脱落,脱落率为31.6%。奥氮平的平均持续治疗时间为(9.7±3.8)个月(1～12个月)。不良反应发生率≥10%的有:体重增加、嗜睡、便秘、口干、静坐不能、震颤、活动减退、头晕、视物模糊等。结论奥氮平长期治疗首发精神分裂症有效,也存在体重增加等不良反应。更多还原

【Abstract】 Objective To explore the long-term effectiveness of olanzapine in the treatment of patients with first-episode schizophrenia,meanwhile to evaluate the adverse events.Methods It was a one-year follow-up study with integrated case management and naturalistic observation.One hundred and thirty-six patients of first-episode schizophrenia were included.Patients met ICD-10 criteria for schizophrenia or schizophreniform disorder and were treated with olanzapine,the dose of which was not fixed.Clinical status was assessed with the Positive and Negative Syndrom Scale(PANSS)and the Treatment Emergent Symptom Scale(TESS).Response was defined as improvement in PANSS total score of ≥50%.Results The response rates at the end of 2,3,6,8,12 months were 50%(65/129),57%(71/125),63%(70/69),71%(73/103),75%(70/93),respectively.There were 101 patients who achieved response,and 17 of whom relapsed.Forty-three patients only completed partial follow-up assessments,so the drop-out rate was 31.6%.The mean time to the discontinuation was(9.7±3.8)months(range:1~12 months).The adverse events reported in ≥10% of patients were weight gain,somnolence,constipation,dry mouth,akathisia,tremor,sedation,dizziness and blurred vision.Conclusions Olanzapine was effective for patients with first-episode schizophrenia,yet the adverse events such as weight gain must be considered.更多还原