Abstract：Objective To investigate the effect of Ziprasidone combined with Olanzapine therapy on myocardial zymogram and brain neurotransmitters in patients with first-episode schizophrenia. Methods One hundred and sixteen patients with first-episode schizophrenia admitted to the Department of Psychiatry, Lishui Second People′s Hospital from July 2016 to October 2017 were enrolled. The prospective study method was used and the patients were divided into treatment group and control group according to the random number table method with 58 cases in each group. The control group was given Olanzapine, and the treatment group was given Ziprasidone combine with Olanzapine orally. After 8 weeks of treatment, clinical efficacy, myocardial zymogram, neurotransmitter, and adverse reaction rate were compared between the two groups. Results The effective rate of the treatment group was 94.83%, which was significantly higher than 82.76% of the control group (P ＜ 0.05). The serum creatine kinase isoenzyme-MB (CK-MB), lactate dehydrogenase (LDH) and sspartate aminotransferase (AST) of the treatment group were significantly lower than the control group (P ＜ 0.05), while dopamine (DA) and γ-aminobutyric acid (GABA) were significantly higher than the control group, acetylcholine (Ach) and deep inhibitory neurotransmitters (INH) were significantly lower than the control group (P ＜ 0.05 or P ＜ 0.01). There was no significant difference in adverse reaction rate between the two groups (P ＞ 0.05). Conclusion The combination therapy of Ziprasidone and Olanzapine can improve the clinical efficacy of patients with first-episode schizophrenia, and it is safe and reliable. The mechanism may be related to the factors such improving myocardial zymogram and regulating brain neurotransmitters.
宋清海 朱桂东 金国林 夏朝云. 齐拉西酮联合奥氮平方案对首发精神分裂症患者心肌酶谱及脑部神经递质的影响[J]. 中国医药导报, 2018, 15(34): 89-92.
SONG Qinghai ZHU Guidong JIN Guolin XIA Chaoyun. Effect of Ziprasidone combined with Olanzapine therapy on myocardial zymogram and brain neurotransmitters in patients with first-episode schizophrenia. 中国医药导报, 2018, 15(34): 89-92.
[1] 孙梦夕，马骏，王灌潇，等.抗精神病药物治疗急性精神分裂平的早期反应情况及相关因素分析[J].中华医学杂志，2017，97（31）：2425-2430.
[2] Bogers JP，Schulte PF，Broekman TG，et al. Dose reduction of high-dose first-generation antipsychotics or switch to ziprasidone in long-stay patients with schizophrenia：A 1-year double-blind randomized clinical trial [J]. Eur Neuropsychopharmacol，2018，28（9）：1024-1034.
[3] Moller M，Swaneopel T，Harvey BH. Neurodevelopmental Animal Models Reveal the Convergent Role of Neurotransmitter Systems，Inflammation，and Oxidative Stress as Biomarkers of Schizophrenia：Implications for Novel Drug Development [J]. ACS Chem Neruosci，2015，6（7）：987-1016.
[4] 中华医学会精神科分会.中国精神疾病分类与诊断标准[M].3版.济南：山东科学技术出版社，2001：75-68.
[5] 赵燕，刘辉，李旸，等.利培酮治疗首发精神分裂症停药前用药时间与临床疗效的关系[J].国际精神病学杂志，2016，43（3）：414-417.
[6] 杜雷，朱义江，宋天彬，等.功能磁共振成像在精神分裂症患者中的研究进展[J].中日友好医院学报，2017，31（1）：36-39.
[7] 杨秀成，何呈刚，苏静，等.山东省莱芜市15岁及以上人群精神障碍流行病学调查[J].临床精神病学杂志，2017， 27（1）：56-58.
[8] 王剑.无抽搐电休克联合齐拉西酮治疗女性难治性精神分裂症的临床疗效分析[J].国际医药卫生导报，2018，24（3）：334-337.
[9] 李静，袁捷，赵娜，等.彩色多普勒超声检测长期服药对精神病患者腹部脏器以及下肢动脉血流的影响[J].中国医学装备，2016，13（12）：51-54.
[10] 王少亭，袁腾飞，戴雯，等.超高效液相色谱-串联质谱检测血浆抗精神分裂症药物浓度方法学的建立及药物浓度参考范围的评价[J].中华检验医学杂志，2017， 40（10）：787-792.
[11] Chen J，Pan X，Qian M，et al. Efficacy and Metabolic Influence on Blood-Glucose and Serum Lipid of Ziprasidone in the Treatment of Elderly Patients with First-Episode Schizophrenia [J]. Shanghai Arch Psychiatry，2017，29（2）：104-110.
[12] 王丹，宁夔，王传升.齐拉西酮联合改良性电休克治疗首发精神分裂症患者的疗效及对患者代谢指标的影响[J].药品评价研究，2017，40（2）：241-244.
[13] 邵文良，吕望强.齐拉西酮联合小剂量奥氮平治疗伴抑郁症状精神分裂症的疗效观察及对脂代谢的影响[J].中国基层医药，2015，22（7）：1014-1017.
[14] Vernal DL，Kapoor S，Al-Jadiri A，et al. Outcome of Youth with Early-Phase Schizophrenia-Spectrum Disorders and Psychosis Not Otherwise Specified Treated with Second-Generation Antipsychotics：12 Week Results from a Pro-spective， Naturalistic Cohort Study [J]. J Child Adolesc Psychopharmacol，2015，25（7）：534-847.
[15] 严叶良，李达，张琰，等.阿立哌唑联合奥氮平对老年精神分裂症患者糖脂代谢及心肌酶的影响[J].国际精神病学杂志，2017，44（6）：981-983.
[16] 陈耿谊，高镇松，张胜佳，等.齐拉西酮与氯氮平对精神分裂症患者心电图和心肌酶的影响[J].临床心身疾病杂志，2015，21（1）：4-6.
[17] 吴琼芳，成晓洁，李侃，等.齐拉西酮复合丙戊酸钠用于难治性精神分裂症治疗的临床疗效分析[J].中国当代医药，2016，23（25）：51-52，55.
[18] 王新，王立阳，周爱化.奥氮平、利培酮及氯氮平治疗精神分裂症对心肌酶的影响[J].医学检验与临床，2013， 24（1）：14-15，29.
[19] 董文凤，姚树永，曹敏娟，等.第二代抗精神病药物奥氮平致代谢失衡的干预措施研究进展[J].中国医药导报，2018，15（4）：43-46.
[20] Miyata Y，Nakamoto H，Neckers L. The therapeutic terget Hsp90 and cancer hallmarks [J]. Curr Pharm Des，2013， 19（3）：347-365.
[21] Stephenson JA，Al-Taan O，Arshad A，et al. The multifaceted effects of oega-3 polyunsaturated fatty acids on the hallmarks of cancer [J]. J Lipids，2013，2013：261247.
[22] 蒋帅，吴银侠，王大刚，等.精神分裂症、神经症、抑郁症患者脑电超慢涨落图分析[J].山东医药，2014，54（20）：1-4，8.
[23] Ning H，Cao D，Wang H，et al. Effects of haloperidol，olanzapine，ziprasidone，and PHA-543613 on spatial learning and memory in the Morris water maze test in na?觙ve and MK-801-treated mice [J]. Brain Behav，2017， 7（8）：e00764.
[24] 王晓良，沈婷，王飚，等.齐拉西酮和奥氮平合并无抽搐电休克对精神分裂症的疗效和安全性及代谢影响的对照研究[J].中国药物与临床，2016，16（2）：282-285.
[25] 徐德毅，李琴繁，易军，等.精神分裂症患者DRD1-48A/G基因多态性与工作记忆能力的关系分析[J].疑难病杂志，2016，15（12）：1271-1274.
[26] 黄淑燕.齐拉西酮与奥氮平治疗早期精神分裂症的疗效与安全性[J].中国医学创新，2016，13（10）：1-4.
2018, Vol. 15 
京公网安备 11010502046598号