[1]张华,王斌,付佳佳,等.喹硫平联合碳酸锂治疗青少年双相情感障碍Ⅰ型躁狂相的疗效及对患者认知功能和生活质量的影响[J].新乡医学院学报,2023,40(9):840-845.[doi:10.7683/xxyxyxb.2023.09.007]
　ZHANG Hua,WANG Bin,FU Jiajia,et al.Curative effect of quetiapine combined with lithium carbonate for adolescent bipolar disorder type Ⅰ manic phase and its effect on cognitive function and quality of life of patients[J].Journal of Xinxiang Medical University,2023,40(9):840-845.[doi:10.7683/xxyxyxb.2023.09.007]
点击复制

喹硫平联合碳酸锂治疗青少年双相情感障碍Ⅰ型躁狂相的疗效及对患者认知功能和生活质量的影响
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年9
页码:
840-845
栏目:
临床研究
出版日期:
2023-09-05

文章信息/Info

Title:
Curative effect of quetiapine combined with lithium carbonate for adolescent bipolar disorder type Ⅰ manic phase and its effect on cognitive function and quality of life of patients
作者:
张华; 王斌; 付佳佳; 孟苓苓; 王晓明; 宋雯
（石家庄市第八医院精神病科，河北　石家庄　050081）
Author(s):
ZHANG Hua; WANG Bin; FU Jiajia; MENG Lingling; WANG Xiaoming; SONG Wen
(Department of Psychiatry,the Eighth Hospital of Shijiazhuang,Shijiazhuang 050081,Hebei Province,China)
关键词:
双相情感障碍; 躁狂; 青少年; 喹硫平; 碳酸锂
Keywords:
bipolar disorder; mania; adolescent; quetiapine; lithium carbonate
分类号:
R749.4
DOI:
10.7683/xxyxyxb.2023.09.007
文献标志码:
A
摘要:
目的　探讨喹硫平联合碳酸锂治疗青少年双相情感障碍Ⅰ型躁狂相的疗效及对患者认知功能及生活质量的影响。
方法　选择2019年2月至2020年2月石家庄市第八医院精神病科收治的74例青少年双相情感障碍Ⅰ型躁狂相患者为研究对象，按照简单随机化法将患者分为对照组和观察组，每组37例。对照组患者给予碳酸锂治疗，疗程为8周；观察组患者给予喹硫平联合碳酸锂治疗，疗程为8周。采用倍克-拉范森躁狂评定量表 (BRMS)评分评估2组患者治疗前后躁狂严重程度，采用临床总体印象-双相情感障碍疾病严重程度量表（CGI-BP-s）评分评估2组患者治疗前后双相障碍严重程度，采用生活质量综合评定问卷-74（GQOLI-74）评分评估2组患者治疗前后的生活质量，采用可重复的成套神经心理状态测验（RBANS)评分评估2组患者的认知功能。比较2组患者的疗效及治疗期间不良反应发生情况。
结果　治疗前，2组患者的BRMS、CGI-BP-s、各项GQOLI-74评分及各项认知功能评分比较差异均无统计学意义（P>0.05）。治疗后，2组患者的BRMS、CGI-BP-s评分显著低于治疗前（P<0.05），各项GQOLI-74评分、各项认知功能评分显著高于治疗前（P<0.05）。治疗后，对照组患者中显效13例，有效14例，无效10例，总有效率为72.97%（27/37）；观察组患者中显效19例，有效13例，无效5例，总有效率为86.49%（32/37）；观察组患者的总有效率显著高于对照组（χ2=3.331，P<0.05）。对照组患者发生腹泻2例，便秘1例，恶心呕吐2例，头晕嗜睡2例，震颤1例，乏力4例，口干1例，不良反应发生率为35.14%（13/37）；观察组患者发生腹泻2例，便秘1例，恶心呕吐3例，头晕嗜睡1例，低血压2例，震颤1例，乏力3例，口干1例，不良反应发生率为37.84%（14/37）；2组患者的不良反应发生率比较差异无统计学意义（χ2=0.778，P>0.05）。
结论　喹硫平联合碳酸锂治疗青少年双相情感障碍I型躁狂相的效果优于单纯碳酸锂治疗，能有效改善患者的认知功能和生活质量，且不增加不良反应。
Abstract:
Objective　To investigate the curative effect of quetiapine combined with lithium carbonate for adolescent bipolar disorder type I manic phase and its effect on cognitive function and quality of life of patients.
Methods　A total of 74 adolescent patients with bipolar disorder type Ⅰ mania admitted to the Department of Psychiatry,the Eighth Hospital of Shijiazhuang from February 2019 to February 2020 were selected as the research objects.According to the simple randomization method,they were divided into the control group and the observation group,with 37 cases in each group.The patients in the control group were treated with lithium carbonate for 8 weeks;the patients in the observation group were treated with quetiapine combined with lithium carbonate for 8 weeks.The severity of mania of patients in the two groups was evaluated by using the Bech-Rafaelsen mania rating scale(BRMS) score before and after treatment;the severity of bipolar disorder of patients in the two groups was evaluated by using the clinical global impression-bipolar disorder-severity of illness scale (CGI-BP-s) score before and after treatment;the quality of life of patients in the two groups was evaluated by using the generic quality of life inventory-74(GQOLI-74) score before and after treatment;the cognitive function of patients in the two groups was evaluated by using the repeatable battery for the assessment of neuropsychological status (RBANS) score.The efficacy and the occurrence of adverse reactions during treatment of patients were compared between the two groups.
Results　Before treatment,there was no significant difference in BRMS,CGI-BP-s,each GQOLI-74 scores and each cognitive function scores of patients between the two groups (P>0.05).After treatment,BRMS and CGI-BP-s scores of patients in the two groups were significantly lower than those before treatment (P<0.05),each GQOLI-74 scores and each cognitive function scores were significantly higher than those before treatment (P<0.05).After treatment,in the control group,13 cases were excellent,14 cases were effective,10 cases were ineffective,and the total effective rate was 72.97%(27/37);in the observation group,19 cases were excellent,13 cases were effective,5 cases were ineffective,and the total effective rate was 86.49% (32/37).The total effective rate of patients in the observation group was significantly higher than that in the control group (χ2=3.331,P<0.05).In the control group,diarrhea occurred in 2 cases,constipation in 1 case,nausea and vomiting in 2 cases,dizziness and lethargy in 2 cases,tremor in 1 case,fatigue in 4 cases,dry mouth in 1 case;and the incidence of adverse reactions was 35.14% (13/37).In the observation group,diarrhea occurred in 2 cases,constipation in 1 case,nausea and vomiting in 3 cases,dizziness and lethargy in 1 case,hypotension in 2 cases,tremor in 1 case,fatigue in 3 cases,dry mouth in 1 case;the incidence of adverse reactions was 37.84%(14/37).There was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.778,P>0.05).
Conclusion　The curative effect of quetiapine combined with lithium carbonate in the treatment of adolescent bipolar disorder type I manic phase is better than lithium carbonate alone, and which can effectively improve the cognitive function and quality of life of patients, without increasing adverse reactions.

参考文献/References:

［1］　FARIAS C A,CARDOSO T A，MONDIN T C,et al.Clinical outcomes and childhood trauma in bipolar disorder:a community sample of young adults［J］.Psychiatry Res,2019,275（5）:228-232.
［2］　KALMAN J L,OLDE LOOHUIS L M,VREEKER A,et al.Characterisation of age and polarity at onset in bipolar disorder［J］.Br J Psychiatry,2021,219（6）:659-669.
［3］　MEHRHOF S Z,POPEL N,MIO M,et al.Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder［J］.Braz J Psychiatry,2021,43(2):147-152.
［4］　ELSAYED O H,PAHWA M,El-MALLAKH R S.Pharmacologic treatment and management of bipolar disorder in adolescents［J］.Expert Opin Pharmacother,2022,23(10):1165-1179.
［5］　刘海艳,钟伟英.富马酸喹硫平片联合碳酸锂治疗青少年双相情感障碍狂躁发作的效果及对认知功能的影响［J］.实用中西医结合临床,2021,21(15):103-104.
LIU H Y,ZHONG W Y.Efficacy of quetiapine fumarate tablets combined with lithium carbonate in the treatment of manic episodes in adolescents with bipolar disorder and its effect on cognitive function［J］.Pract Clin J Integr Trad Chin West Med,2021,21(15):103-104.
［6］　NESTSIAROVICH A,GAUDIOT C E S,BALDESSARINI R J,et al.Preventing new episodes of bipolar disorder in adults:systematic review and meta-analysis of randomized controlled trials［J］.Eur Neuropsychopharmacol，2022,54(1):75-89.
［7］　美国精神医学学会.精神障碍诊断与统计手册（第五版）［M］.张道龙,译.北京:北京大学出版社,2016:119-120.
AMERICAN PSYCHIATRIC ASSOCIATION.Diagnostic and statistical manual of mental disorders fifth edition［M］.ZHANG D L,Trans.Beijing:Peking University Press,2016:119-120.
［8］　张明园.倍克-拉范森躁狂量表(BRMS)［J］.上海精神医学,1984,4(2):66-67.
ZHANG M Y.Bech-Rafaelsen Mania Rating Scale,BRMS［J］.Shanghai Psychiatry,1984,4(2):66-67.
［9］　温柏玲.奥氮平联合碳酸锂治疗双相情感障碍躁狂发作的临床观察［J］.中外医学研究,2020,18(2):168-170.
WEN B L.Clinical observation of olanzapine combined with lithium carbonate in the treatment of manic episodes of bipolar disorder［J］.Chin For Med Res,2020,18(2):168-170.
［10］　李华芳.精神药物临床研究常用量表［M］.上海：上海科技教育出版社,2011:120.
LI H F.Common scales for clinical research on psychotropic drugs［M］.Shanghai：Shanghai Science and Technology Education Press,2011:120.
［11］　SONG Q H,SHEN G Q,XU R M,et al.Effect of Tai Chi exercise on the physical and mental health of the elder patients suffered from anxiety disorder［J］.Int J Physiol Pathophysiol Pharmacol，2014,6(1):55-60.
［12］　成燕,李春波,吴文源.可重复的成套神经心理状态测验的应用评价［J］.中华精神科杂志,2010,43(1):57-60.
CHENG Y,LI C B,WU W Y.Evaluation of the application of repeatable battery for the assessment of neuropsychological status［J］.Chin J Psychiatry,2010,43(1):57-60.
［13］　孙平平.丙戊酸镁缓释片治疗双相情感障碍躁狂相患者的效果［J］.中国民康医学,2021,33(20):82-84.
SUN,P P.Effects of Magnesium valproate sustained-release tablets on patients with manic phase of bipolar disorder［J］. Med J Chin Peopl Health,2021,33(20):82-84.
［14］　CICHO N＇ L,JANAS-KOZIK M,SIWIEC A,et al.Clinical picture and treatment of bipolar affective disorder in children and adolescents［J］.Psychiatr Pol,2020,54(1):35-50.
［15］　张恩,宋传福,熊伟,等.丙戊酸镁缓释片对双相情感障碍躁狂发作患者疗效及血清IL-1β、TNF-α、GSH-PX、SOD水平的影响［J］.内蒙古医科大学学报,2020,42(3):265-267,278.
ZHANG E,SONG C F,XIONG W,et al.To investigate the effect of magnesium valproate sustained-release tablets on serum IL-1β,TNF-α,GSH-PX and SOD levels in patients with manic episode of bipolar disorder［J］.J Inner Mongolia Med Univ,2020,42(3):265-267,278.
［16］　VERDOLINI N,HIDALGO-MAZZEI D,DEL MATTO L,et al.Long-term treatment of bipolar disorder type I:a systematic and critical review of clinical guidelines with derived practice algorithms［J］.Bipolar Disord,2021,23(4):324-340.
［17］　NARDI A E,DA SILVA A G,GENTIL FILHO V.Where are lithium carbonate,typical antipsychotics,imipramine,and some other efficacious medications［J］.Braz J Psychiatry,2021,43(1):2-3.
［18］　戴慧,李鸣,端木彦涛,等.碳酸锂抗躁狂症的临床应用进展及不良反应分析［J］.中国药物警戒,2021,18(3):294-299.
DAI H,LI M,DUANMU Y T,et al.Clinical application and adverse reactions of lithium carbonate in anti-mania［J］.Chin J Pharmacovigil,2021,18(3):294-299.
［19］　张春友,孙继北,史翠路.托吡酯联合喹硫平对精神分裂症的疗效及糖脂代谢的影响［J］.西北药学杂志,2023,38(3):162-166.
ZHANG C Y,SUN J B,SHI C L.Efficacy of topiramate combined with quetiapine in the treatment of schizophrenia and its effect on glucose and lipid metabolism inpatients［J］.Northwest Pharmaceutical J,2023,38(3):162-166.
［20］　ZAREZADEH F,ARBABI M,SHAMABADI A,et al.Levetiracetam adjunct to quetiapine for the acute manic phase of bipolar disorder: a randomized,double-blind and placebo-controlled clinical trial of efficacy,safety and tolerability［J］.Int Clin Psychopharmacol,2022,37(2):46-53.
［21］　RIBOLSI M,MAGNI V,RUBINO I A.Quetiapine fumarate for schizophrenia and bipolar disorder in young patients［J］.Drugs Today (Barc),2010,46(8):581-587.
［22］　LEI D, LI W, TALLMAN M J,et al.Changes in the brain structural connectome after a prospective randomized clinical trial of lithium and quetiapine treatment in youth with bipolar disorder［J］.Neuropsychopharmacology,2021,46(7):1315-1323.
［23］　PATINO L R,KLEIN C C,STRAWN J R.A randomized,double-blind,controlled trial of lithium versus quetiapine for the treatment of acute mania in youth with early course bipolar disorder ［J］.J Child Adolesc Psychopharmacol,2021,31(7):485-493.
［24］　YATHAM L N,CHAKRABARTY T,BOND DAVID J,et al.Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations［J］.Bipolar Disord,2021,23(8):767-788.
［25］　HABIBI N,DODANGI N,NAZERI A.Comparison of the effect of lithium plus quetiapine with lithium plus risperidone in children and adolescents with bipolar I disorder:a randomized clinical trial［J］.Med J Islam Repub Iran,2017,31:1-7.
［26］　杨辉.喹硫平或丙戊酸镁联合碳酸锂对双相情感障碍躁狂发作患者PANSS、BRMS评分的影响［J］.中国现代医生,2021,59(30):10-12,17.
YANG H.The effect of quetiapine or magnesium valproate combined with lithium carbonate on PANSS and BRMS scores in patients with bipolar disorder manic episode［J］.China Mod Doc，2021,59(30):10-12,17.
［27］　袁宁.双心境稳定剂结合喹硫平片治疗双相情感障碍躁狂发作患者的疗效［J］.中国误诊学杂志,2021,16(3):213-215.
YUAN N.The efficacy of dual mood stabilizer combined with quetiapine tablets for patients with bipolar disorder manice pisode［J］.Chin J Misd，2021,16(3):213-215.
［28］　BARBOSA I G,LEITE F D M C,BERTOUX M,et al.Social cognition across bipolar disorder and behavioral variant frontotemporal dementia: an exploratory study［J］.Braz J Psychiatry,2023,45(2):132-136.
［29］　CHUMAKOV E M,PETROVA N N,LIMANKIN O V,et al.Cognitive impairment in remitted patients with bipolar disorder［J］.Zh Nevrol Psikhiatr Im S S Korsakova,2021,121(4):12-18.
［30］　张佳佳,芮琴琴,王龙,等.双相Ⅰ型障碍躁狂发作患者冲动性与认知功能的研究［J］.中华行为医学与脑科学杂志,2019,28(5):407-411.
ZHANG J J,RUI Q Q,W L,et al.Study on impulsivity and cognitive function in patients with manic episodes of bipolar Ⅰ disorder［J］.Chin J Behav Med Brain Sci,2019,28(5):407-411.
［31］　XU X,XIANG H,QIU Y,et al.Sex differences in cognitive function of first-diagnosed and drug-naive patients with bipolar disorder［J］.J Affect Disord,2021,295:431-437
［32］　SERAFINI G,POMPILI M,BORGWARDT S,et al.Brain changes in early-onset bipolar and unipolar depressive disorders: a systematic review in children and adolescents［J］.Eur Child Adolesc Psychiatry,2014,23(11):1023-1041.
［33］　贾同钰,孟庆民,崔栋,等.青少年双相障碍躁狂相患者功能磁共振成像镜像同伦连接［J］.泰山医学院学报,2020,41(11):801-806.
JIA T Y,MENG Q M,CUI D,et al.Voxel-mirrored homotopic connectivity in mania patients with pediatric bipolardisorder:a resting-state fMRI study［J］.J Taishan Med Coll,2020,41(11):801-806.
［34］　STREICHER J V,WEN H,BLOM T J，et al.A preliminary study of the effects of treatment with lithium versus quetiapine on attention of adolescents with bipolar disorder［J］.J Child Adolesc Psychopharmacol,2020,30(7):465-469.
［35］　王湖,曾奇佳,马长林.喹硫平联用碳酸锂治疗双相情感障碍躁狂发作的临床效果［J］.心理月刊,2022,17(4):32-34.
WANG H,ZENG Q J,MA C L.The clinical effect of quetiapine combined with lithium carbonate in the treatment of manic episodes of bipolar disorder［J］.PSY,2022,17(4):32-34.
［36］　王晓利.碳酸锂联合喹硫平对双相情感障碍患者执行力及记忆力水平的影响［J］.黑龙江中医药,2021,50(4):141-142.
WANG X L.Effect of lithium carbonate combined with quetiapine on executive function and memory in patients with bipolar disorder［J］.Heilongjiang J Trad Chin Med,2021,50(4):141-142.
［37］　ISLAM M K，ISLAM M S,KIBRIA S M,et al.Quality of life among patients with bipolar disorder［J］.Mymensingh Med J,2020,29(3):601-608.

相似文献/References:

[1]季卫东,郭本玉,李宁,等.双相情感障碍脑电地形图研究[J].新乡医学院学报,1994,11(02):141.

更新日期/Last Update: 2023-09-05