超聲對精神分裂癥首次用藥后胃排空影響的研究

【摘 要】 目的 探討超聲對分別首次服用奧氮平和阿立哌唑的精神分裂癥患者胃排空功能的影響。方法 40例精神分裂癥首次發病患者隨機服用奧氮平和阿立哌唑各20例，用實時二維B超胃竇單切面法測量治療前及治療4周后空腹胃竇面積（S空腹）、胃排空時間（T）、胃竇收縮頻率（F）、胃竇收縮幅度（△S），觀察藥物對各項胃動力指標的影響。結果 奧氮平組治療前胃排空時間為57.04±9.86min，治療后為52.35±9.86min，經藥物治療后，奧氮平組較治療前胃排空時間變短。奧氮平組治療前胃竇收縮幅度、收縮頻率分別為2.09±0.59cm2和2.72±0.35次/分，治療后分別為2.60±0.73cm2和2.98±0.70次/分，較治療前胃竇收縮幅度增大、收縮頻率加快。阿立哌唑組治療前胃排空時間為62.69±12.09min，治療后為64.81±12.16min，胃竇收縮幅度、收縮頻率分別為2.68±0.83cm2和3±0.90次/分，治療后分別為2.62±0.73cm2和2.75±0.86次/分，阿立哌唑組治療前后各項指標變化無明顯差異。結論 奧氮平組精神分裂癥患者胃排空加快，胃竇收縮幅度增大、收縮頻率加快，胃動力改變時患者體重增加的發病機制之一，阿立哌唑組患者胃排空功能無明顯變化。

【關鍵詞】 超聲檢查；精神分裂癥；胃排空；首次用藥

【中圖分類號】 R730.41 【文獻標識碼】 A

【Abstract】 Objective To explore the influence of ultrasonography patients with first-episode Schizophrenia on gastric emptying.Methods 40 patients with first-episode schizophrenia were randomly divided into olanzipine group（20 cases） and aripiprazole group（20 cases） for 4 weeks treatment.Gastric emptying time、antral contraction frequency and antral aera were measured using B-ultrasonography before treatment，Gastric emptying Function was reviewed 4 weeks after treatment.The efficacies of both drugs were assessed. Results In olanzipine group，Gastric emptying time Were 57.04±9.86 min before treatment，after treatment were52.35±9.86 min，the time were quicker than before treatment.antral contraction amplitude and contraction frequency were2.09±0.59cm2 and 2.72±0.35 times/min in olanzipine group，after treatment were 2.60±0.73cm2和2.98±0.70 times/min in olanzipine group，increased significantly after the treatment（P<0.05）.In aripiprazole group，total emptying time were 62.69±12.09 min before treatment，after treatment were 64.81±12.16min，antral contraction amplitude and contraction frequency were 2.68±0.83cm2和3±0.90 times/min，after treatment were 2.62±0.73cm2和2.75±0.86 times/min， Each indexes of aripiprazole group were not changed after the teatment（P>0.05）.Conclusion Gastric empyting rate is quiker than before treatment of olanzapine，the change of gastric emptying rate maybe is one of the fators of obesity in weight weight gain. Each indexes of aripiprazole group were not changed.

【Keywords】 ultrasonography；Schizophrenia；Gastric；emptying first-episode

1 研究對象

研究對象為2011年1月—2012年8月解放軍第102醫院精神科連續住院的首發精神分裂癥患者。將40例入組患者隨機分為奧氮平組與阿立哌唑組，各20例。奧氮平組，男4例，女16例，年齡16-53歲，平均年齡（30.35±9.87）歲；阿立哌唑組，男3例，女17例，年齡16-46歲，平均年齡（24.93±8.33）歲；所有患者均符合《CCMD-3》中精神分裂癥診斷標準，另外（1）患者入院前至少2周內未服用過任何抗精神病藥及影響胃腸動力藥物；……