阿立哌唑治疗儿童孤独症的临床观察

谢琴; 汤珺; 徐杨; 曾红玲

doi:10.7499/j.issn.1008-8830.2013.04.012

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中国当代儿科杂志 ›› 2013, Vol. 15 ›› Issue (4) : 294-297. DOI: 10.7499/j.issn.1008-8830.2013.04.012

论著·临床研究

阿立哌唑治疗儿童孤独症的临床观察

谢琴，汤珺，徐杨，曾红玲

作者信息 +

Clinical observation of aripiprazole in the treatment of autism

XIE Qin, TANG Jun, XU Yang, ZENG Hong-Ling

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摘要

目的：研究阿立哌唑治疗儿童孤独症的临床疗效和安全性。方法：用阿立哌唑对35例4~16岁合并有行为问题的孤独症儿童进行治疗，疗程8周，在治疗前和治疗后2、4、8周采用临床疗效总评量表（CGI）和孤独症治疗评估量表（ATEC）评分，并观察不良反应。结果：治疗第2周末CGI中的病情严重程度评分开始下降（P<0.05），治疗第8周末下降更加显著（P<0.01），疗效评分则于第8周末有显著性提高（P<0.05）。ATEC总分于治疗第8周末明显低于治疗前（P<0.01），各项目分中，语言、感知、行为评分较治疗前均有明显下降（P<0.01），社交评分于治疗前后无明显变化。对自伤自残行为、睡眠障碍、精神病性症状显著改善，对注意缺陷及多动、冲动攻击行为、刻板行为、易激惹也有一定效果。未见严重不良反应。结论：阿立哌唑治疗儿童孤独症有效安全。

Abstract

OBJECTIVE: To study the effect and safety of aripiprazole in the treatment of childhood autism. METHODS: Thirty-five children (aged from 4 to 16 years) with autism presenting as behavioral disorders were treated with aripiprazole for 8 weeks. They were evaluated according to the Clinical Global Impression (CGI) and the Autism Treatment Evaluation Checklist (ATEC) before treatment and at the end of the 2nd, 4th and 8th weeks of treatment. Adverse reactions were observed. RESULTS: The CGI showed illness severity decreased from the second week of aripiprazole treatment (P<0.05) and more significantly decreased illness severity was observed at the end of the 8th week (P<0.01). The curative effect score significantly increased at the end of the 8th week (P<0.05). The ATEC total scores were significantly reduced at the end of the 8th week after aripiprazole treatment. Besides the social intercourse ability, great improvements were shown in verbal communication, apperception and behavioural symptoms after aripiprazole treatment (P<0.01). Self-harm, sleep disorders and psychiatric symptoms were greatly improved after treatment and attention deficit, excessive activities, impulse to attack behavior, stereotyped behaviors and irritability were also improved to some extent. No severe adverse effects were found. CONCLUSIONS: Aripiprazole is safe and effective for the treatment of childhood autism.

导出引用

谢琴，汤珺，徐杨，曾红玲. 阿立哌唑治疗儿童孤独症的临床观察[J]. 中国当代儿科杂志. 2013, 15(4): 294-297 https://doi.org/10.7499/j.issn.1008-8830.2013.04.012

XIE Qin, TANG Jun, XU Yang, ZENG Hong-Ling. Clinical observation of aripiprazole in the treatment of autism[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(4): 294-297 https://doi.org/10.7499/j.issn.1008-8830.2013.04.012

参考文献

［1］郭兰婷，李元媛.我国儿童孤独症临床研究的发展与展望［J］.中国心理卫生杂志，2011,25（26）:460-463.

［2］范鸣.阿立哌唑在美国获准用于治疗孤独症的易怒症状［J］. 药学进展，2010,34（3）：附页2.

［3］刘靖.儿童孤独症的诊断与评估［J］.中国实用儿科杂志，2008,23（3）：59-62.

［4］苏林雁.儿童孤独症的病因及发病机制［J］.实用儿科临床杂志，2010,23(25):1765-1767.

［5］Croonenberghs J, Spaas K, Wauters A, Verkerk R, Scharpe S, Deboutte D, et al. Faulty serotonin-DHEA interactions in autism: Results of the 5-hydroxytryptophan challenge test［J］. Neuro EndocrinolLett, 2008, 29(3): 385-390.

［6］韦斌垣，黄飞，覃小田，梁巧琦.利培酮在治疗孤独症儿童行为问题中的作用［J］.中国当代儿科杂志，2011，13（3）:216-218.

［7］McCracken JT, McGough J, Shah B, Cronin P, Hong D, AmanMG, et al. Risperidone in children with autism and serious behav-ioral problems［J］. N Engl J Med, 2002, 347(5): 314-321.

［8］Fombonne E. Risperidone improves restricted, repetitive, and stereotyped behaviour in autistic children and adolescents［J］. Evid Based Ment Health, 2006, 9(1): 6.

［9］Valicenti M, cDermott MR, Demb HM. Clinical effects and adverse reactions of off-label use of aripiprazole in children and adolescents with developmental disabilities［J］. J Child Adolesc Psychopharmacol, 2006, 16 (5): 49-56.

［10］Marcus RN, Owen R, Kamen L, Manos G, McQuade RD, Carson WH, et al. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder［J］. J Am Acad Child Adolesc Psychiatry, 2009, 48 (11): 1110-1119.

［11］Owen R, Sikich L, Marcus RN, Corey-Lisle P, Manos G, McQuade RD, et al. Aripiprazole in the treatment of irirritability in children and adolescents with autistic disorder［J］. Pediatrics, 2009, 124(6): 1533-1540.

［12］陶国泰.儿童少年精神医学［M］.南京：江苏科学技术出版社，2009：195-196.

［13］舒畅，白雪光，王晓萍，白静. 阿立哌唑治疗儿童孤独症与精神发育迟滞临床观察［J］.临床精神医学杂志，2007,17（5）：333-334.