Effect of Paliperidone Combined with Sertraline in the Treatment of Schizophrenia and its Influence on Serum Neurofunctional Related Factors.

IF 1.3 Q3 PSYCHIATRY
Alpha psychiatry Pub Date : 2025-02-28 eCollection Date: 2025-02-01 DOI:10.31083/AP38775
Meng Gu, Zhilian Pi, Long Zhu, Jun Zhang
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Abstract

Objective: This study aimed to evaluate the efficacy of paliperidone combined with sertraline in treating schizophrenia (SCZ) and its effect on serum neurofunctional factors.

Methods: A retrospective analysis was conducted on SCZ patients admitted between June 2020 and June 2021. Initially, 80 patients were treated with paliperidone, while 36 received a combination of paliperidone and sertraline. Propensity score matching based on 3 covariates resulted in 2 groups: the control group (paliperidone alone, n = 36) and the observation group (paliperidone + sertraline, n = 36). The clinical efficacy, adverse reactions, quality of life scores, serum biomarkers levels related to nerve and liver function, and anxiety and depression levels were compared between the 2 groups.

Results: The observation group demonstrated higher total effectiveness than the control group (p = 0.011). Post-treatment, the scores of all dimensions of quality of life in both groups were improved, and the observation group was higher than the control group (p < 0.001). Post-treatment, the observation group exhibited lower neuron-specific enolase (NSE) and higher neuregulin 1 (NRG1) levels than the control group (p < 0.001). The levels of aminotransferase (AST), total bilirubin (TBiL) and alanine aminotransferase (ALT) increased in both groups post-treatment (p < 0.001). The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-2 (IL-2) decreased in both groups post-treatment, and the observation group had lower levels of these cytokines compared to the control group after treatment (p < 0.001). Post-treatment, Hamilton Anxiety Scale (HAMA) score and Hamilton Depression Scale (HAMD) score decreased in both groups, with the observation group showing lower scores than the control group (p < 0.001). The changes in the scores of various dimensions of quality of life, HAMA and HAMD scores, neurofunctional factors and inflammatory markers levels in the observation group were greater than those in the control group (p < 0.001). There were no serious side effects during and after treatment in both groups.

Conclusions: Paliperidone combined with sertraline effectively improves serum neuregulin levels in SCZ patients, alleviates negative emotional effects without causing liver or kidney damage, and demonstrates excellent clinical efficacy and safety.

研究目的本研究旨在评估帕利哌酮联合舍曲林治疗精神分裂症(SCZ)的疗效及其对血清神经功能因子的影响:对2020年6月至2021年6月期间收治的精神分裂症患者进行回顾性分析。最初,80名患者接受了帕潘立酮治疗,36名患者接受了帕潘立酮和舍曲林的联合治疗。根据3个协变量进行倾向评分匹配,最终分为两组:对照组(单独使用帕利哌酮,n = 36)和观察组(帕利哌酮+舍曲林,n = 36)。比较了两组的临床疗效、不良反应、生活质量评分、与神经和肝功能相关的血清生物标志物水平以及焦虑和抑郁水平:结果:观察组的总有效率高于对照组(P = 0.011)。治疗后,两组患者生活质量各方面的评分均有所提高,观察组高于对照组(P < 0.001)。治疗后,观察组的神经元特异性烯醇化酶(NSE)水平低于对照组,神经胶质蛋白 1(NRG1)水平高于对照组(P < 0.001)。治疗后,两组的转氨酶(AST)、总胆红素(TBiL)和丙氨酸氨基转移酶(ALT)水平均有所上升(P < 0.001)。两组治疗后肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-2(IL-2)水平均下降,观察组治疗后这些细胞因子水平低于对照组(P < 0.001)。治疗后,两组的汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分均有所下降,观察组的评分低于对照组(P < 0.001)。观察组生活质量各方面评分、汉密尔顿焦虑量表和汉密尔顿抑郁量表评分、神经功能因子和炎症标志物水平的变化均大于对照组(P < 0.001)。两组患者在治疗期间和治疗后均未出现严重副作用:帕潘立酮联合舍曲林可有效改善SCZ患者的血清神经胶质细胞水平,缓解不良情绪反应,且不引起肝肾损害,临床疗效和安全性良好。
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