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1. 西安交通大学医学院第一附属医院药学部
2. 西安交通大学医学院第一附属医院风湿科
3. 西安交通大学医学院第一附属医院精神科
纸质出版日期:2021,
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宋鹏飞, 王婷, 李威, 等. 利培酮联合泼尼松龙治疗退化型孤独症谱系障碍患儿的临床研究[J]. 中国医院用药评价与分析, 2021,21(12):1445-1448.
SONG Pengfei, WANG Ting, LI Wei, et al. Prednisolone Combined with Risperidone in the Treatment of Children with Degenerative Autism Spectrum Disorder[J]. 2021,21(12):1445-1448.
宋鹏飞, 王婷, 李威, 等. 利培酮联合泼尼松龙治疗退化型孤独症谱系障碍患儿的临床研究[J]. 中国医院用药评价与分析, 2021,21(12):1445-1448. DOI: 10.14009/j.issn.1672-2124.2021.12.006.
SONG Pengfei, WANG Ting, LI Wei, et al. Prednisolone Combined with Risperidone in the Treatment of Children with Degenerative Autism Spectrum Disorder[J]. 2021,21(12):1445-1448. DOI: 10.14009/j.issn.1672-2124.2021.12.006.
目的:探讨利培酮联合泼尼松龙对退化型孤独症谱系障碍(autism spectrum disorder
ASD)患儿核心症状和炎症因子的影响。方法:选取2018年11月至2020年4月于西安交通大学医学院第一附属医院治疗的退化型ASD患儿218例
根据随机数字表法分为泼尼松龙组和对照组
每组109例。所有患儿均口服利培酮片治疗
连续服用12周。泼尼松龙组患儿在上述治疗的基础上加用泼尼松龙片治疗
1 mg/d
连续服用12周。比较基线期
治疗第4、8和12周两组患儿的儿童孤独症评定量表(childhood autism rating scale
CARS)评分、孤独症行为评定量表各项评分的差异
观察基线期和治疗12周两组患儿的炎症因子水平
记录两组患儿不良反应发生情况。结果:泼尼松龙组患儿治疗第4、8和12周的CARS评分较基线显著降低
差异有统计学意义(F=22.493
P
<
0.001)。泼尼松龙组患儿随时间进展
CARS评分显著降低
差异有统计学意义(F=22.493
P
<
0.001)。泼尼松龙组患儿治疗第4、8和12周情绪不稳/自伤攻击评分(F=3.347
P=0.027)、社会退缩/呆滞评分(F=25.173
P
<
0.001)、刻板行为评分(F=3.179
P=0.032)和多动评分(F=5.347
P=0.003)较基线显著降低
差异均有统计学意义。治疗第12周
泼尼松龙组患儿γ干扰素(t=2.487
P=0.020)、白细胞介素1β(t=5.824
P
<
0.001)、白细胞介素6(t=2.763
P=0.011)和白细胞介素8(t=2.547
P=0.018)水平较基线显著降低
差异均有统计学意义。泼尼松龙组与对照组患儿不良反应发生率比较
差异无统计学意义[2.8%(3/109)与0(0/109)比较
χ
2
=1.352
P=0.245)。结论:利培酮联合泼尼松龙治疗退化型ASD
能够显著改善患儿情绪不稳/自伤攻击、社会退缩/呆滞、刻板行为和多动等核心临床症状
降低炎症反应
安全性高。
OBJECTIVE: To probe into the effects of risperidone combined with prednisolone on core symptoms and inflammatory factors in children with degenerative autism spectrum disorder( ASD). METHODS: Totally 218 children with degenerative ASD admitted into the First Affiliated Hospital of Xi’an Jiaotong University from Nov. 2018 to Apr. 2020 were extracted to be divided into the prednisolone group and the control group via the random number table
with 109 cases in each group. All children were treated with Risperidone tablets for 12 weeks. On the basis of the above treatment
the prednisolone group was treated with Prednisolone tablets at a dose of 1 mg/d for 12 weeks.Differences of childhood Autism Rating Scale( CARS) scores and autism behavior rating scale scores between two groups were compared at baseline
after treatment of 4
8 and 12 weeks. Levels of inflammatory factors in two groups were observed at baseline and after treatment of 12 weeks. The adverse drug reactions of two groups were recorded.RESULTS: The CARS scores of the prednisolone group were significantly lower than those of the baseline after treatment of 4
8 and 12 weeks
and the difference was statistically significant( F = 22. 493
P
<
0. 001). The CARS scores of the prednisolone group decreased significantly over time
and the difference was statistically significant( F =22. 493
P
<
0. 001). Emotional instability/self-harm attack score( F = 3. 347
P = 0. 027)
social withdrawal/sluggishness score( F = 25. 173
P
<
0. 001)
stereotyped behavior score( F = 3. 179
P = 0. 032) and hyperactivity scores( F = 5. 347
P = 0. 003) of the prednisolone group were significantly lower than those of the baseline after treatment of 4
8 and 12 weeks
and the differences were statistically significant. After treatment of 12 weeks
the interferon-γ( t = 2. 487
P = 0. 020)
interleukin-1β( t = 5. 824
P
<
0. 001)
interleukin-6( t = 2. 763
P = 0. 011)
interleukin-8( t = 2. 547
P = 0. 018) off the prednisolone group were significantly lower than those of the baseline
with statistically significant differences. There was no significant difference in the incidence of adverse drug reactions between the prednisolone group and the control group[2. 8%( 3/109) compared with 0( 0/109)
χ
2
= 1. 352
P = 0. 245]. CONCLUSIONS: Risperidone combined with prednisolone in the treatment of degenerative ASD can significantly improve the core clinical symptoms of emotional instability/self-harm attack score
social withdrawal/sluggishness
stereotyped behavior and hyperactivity
and reduce the inflammatory response of patients with higher safety.
泼尼松龙孤独症谱系障碍利培酮
PrednisoloneAutism spectrum disorderRisperidone
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