2019 年第 12 期 第 14 卷

经颅磁刺激联合齐拉西酮胶囊对精神分裂症患者代谢指标及血清神经营养因子水平的影响

Effect of transcranial magnetic stimulation combined with ziprasidone capsules on metabolic indexes and serum neurotrophic factor in patients with schizophrenia

作者：罗海东林荫刘向来

英文作者：

单位：571100海口，海南省安宁医院心理咨询治疗中心

英文单位：

关键词：精神分裂症；经颅磁刺激；齐拉西酮；代谢指标

英文关键词：

• 摘要：

• 【摘要】目的    探讨经颅磁刺激联合齐拉西酮胶囊对精神分裂症患者代谢指标及血清神经营养因子水平的影响。方法    选择2017年2月至2018年8月在海南省安宁医院进行治疗的精神分裂症患者 86例，按照随机数字表法分为对照组和观察组，各43例，对照组给予齐拉西酮胶囊口服，观察组在对照组基础上增加经颅磁刺激。分析治疗效果，比较2组治疗前后的糖脂代谢指标、精神病症状评分、血清泌乳素水平和体重指数、血清神经营养因子水平及不良反应发生情况。结果    治疗后2组空腹血糖、总胆固醇水平均较治疗前降低，且观察组低于对照组［（5.1±0.4）mmol/L比（5.7±0.4）mmol/L、（4.0±0.3）mmol/L比（4.2±0.6）mmol/L］；空腹胰岛素水平均较治疗前升高，且观察组高于对照组［（13.2±2.0）mIU/L比（9.1±0.9）mIU/L］，差异均有统计学意义（均P<0.05）。治疗后2组阳性症状评分、一般精神病理评分及观察组阴性症状评分均较治疗前降低，且观察组阴性症状评分低于对照组，差异均有统计学意义（均P<0.05）。2组患者治疗前后组内、组间比较血清泌乳素水平和体重指数差异均无统计学意义（均P>0.05）。治疗后，2组血清神经营养因子水平均较治疗前增高，且观察组高于对照组［（43±5）μg/L比（40±4）μg/L］，差异有统计学意义（t=-3.928，P<0.001）。2组体位性低血压、锥体外系反应、恶心、呕吐、视物模糊的发生率差异均无统计学意义（均P>0.05）。结论    使用经颅磁刺激联合齐拉西酮胶囊治疗精神分裂症患者，可以改善糖脂代谢指标和血清神经营养因子水平，改善阴性症状，安全性良好。

• 【Abstract】Objective    To investigate the effect of transcranial magnetic stimulation combined with ziprasidone capsules on metabolic indexes and serum neurotrophic factor in patients with schizophrenia. Methods    A total of 86 patients with schizophrenia admitted to Hainan Provincial Anning Hospital from February 2017 to August 2018 were randomly divided into control group and observation group, with 43 cases in each group. The control group took ziprasidone capsules, while the observation group was treated with transcranial magnetic stimulation and ziprasidone capsules. Clinical efficacy, glucose and lipid metabolism markers, psychiatric symptom score, serum prolactin level, body mass index, serum neurotrophic factor level and adverse reactions were analyzed. Results    After treatment, fasting blood sugar and total cholesterol levels decreased in both groups, and those in observation group were lower than those in control group［（5.1±0.4）mmol/L vs （5.7±0.4）mmol/L, （4.0±0.3）mmol/L vs （4.2±0.6）mmol/L］; fasting insulin level increased in both groups, and those in observation group were higher than those in control group［（13.2±2.0）mIU/L vs （9.1±0.9）mIU/L］, with statistical significances(all P<0.05). Scores of positive symptoms, general psychopathology and negative symptoms decreased after treatment; negative symptoms score in observation group was lower than that in control group, with statistical significances(all P<0.05). There were no significant between-group differences in serum prolactin level and body mass index before and after treatment(all P>0.05). After treatment, serum neurotrophic factor level significantly increased in both groups and it was significantly higher in observation group than that in control group［（43±5）μg/L vs （40±4）μg/L］(t=-3.928, P<0.001). There were no significant differences in the incidences of postural hypotension, extrapyramidal reaction, nausea, vomiting and blurred vision between groups(all P>0.05). Conclusion    Transcranial magnetic stimulation combined with ziprasidone capsules treating schizophrenia can improve glucose and lipid metabolism markers, serum neurotrophic factor level and ameliorate negative symptoms with good safety.