目的 比较鲁拉西酮与奥氮平用于治疗女性急性期精神分裂症患者的疗效，以及其对体质量、糖脂代谢风险的影响。以期为女性急性期的精神分裂症患者抗精神病药物的选择提供参考。方法 连续选取于2022年4月—2024年4月内江门市第三人民医院收治的女性急性期精神分裂症患者80例，采用计算机随机分组法将患者分为治疗组与阳性药物对照组进行对照。治疗组40例口服鲁拉西酮40~80 mg/d，阳性药物对照40例组口服奥氮平5~20 mg/d。分别测量两组治疗前（基线）以及连续用药治疗2、4、6周后的PANSS量表评分，以及治疗后的代谢指标［体质量指数（BMI）、血清空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）、载脂蛋白E（ApoE），并将治疗组与对照组前后疗效及各项代谢指标进行比较分析。结果 两组的总有效率比较差异无统计学意义（χ 2 =1.569，P＞0.05）；两组治疗前后PANSS量表评分的时间-组别效应与组别效应均无统计学意义（χ 2 =0.466、3.640，P=0.926、0.056），时间主效应显著（χ 2 =363.24，P＜0.001）。两组TG、TC、HDL、ApoA、ApoB存在组别-时间交互效应（χ 2 =7.562、5.991、6.163、6.958、4.397，P=0.006、0.014、0.013、0.008、0.036），两组TG、ApoA时间主效应显著（χ 2 =33.473、8.846，P＜0.001、0.003），两组ApoA组别效应显著（χ 2 =4.889，P=0.027）。结论 与奥氮平相比，鲁拉西酮治疗女性急性期精神分裂症的疗效相当，且对代谢指标影响更小。
Objective To compare the efficacy of lurasidone and olanzapine in the treatment of female patients with acute schizophrenia，as well as their effects on body mass，glucose and lipid metabolism risk．To provide reference for the selection of antipsychotic drugs for female patients with acute schizophrenia．Methods From April 2022 to April 2024，80 female patients with acute phase schizophrenia admitted to the Third People’s Hospital of Jiangmen City were selected as samples and included in the study．The patients were randomly divided into a treatment group and a positive drug control group using a computer randomization method for comparison．The treatment group took oral lorazepine tablets（40 cases；40-80 mg/d），while the positive drug control group took oral olanzapine tablets（40 cases；5-20 mg/d）．The Positive and Negative Symptom Scale（PANSS）scores of two groups before treatment（baseline）and after 2，4，and 6 weeks of continuous medication treatment were measured，as well as metabolic indicators after treatment （body mass index［BMI］，serum fasting blood glucose［FPG］，total cholesterol［TC］，triglycerides［TG］，high-density lipoprotein［HDL］，low-density lipoprotein［LDL］，apolipoprotein A［ApoA］，apolipoprotein B［ApoB］，apolipoprotein E［ApoE］），and the efficacy and various metabolic indicators between the treatment group and the control group before and after treatment were compared and analyzed．Results The total effective rate of the two groups was not statistically significant（χ 2 =1.569，P＞0.05）．The time-group effect and group effect of PANSS scores before and after treatment in both groups were not statistically significant（χ 2 =0.466，3.640，P=0.926，0.056），while the time main effect was significant（χ 2 =363.24，P＜0.001）．There was a group-time interaction effect between two groups of TG，TC，HDL，ApoA，and ApoB（χ 2 =7.562，5.991，6.163，6.958，4.397，P=0.006，0.014，0.013，0.008，0.036）．The time main effect of TG and ApoA was significant in both groups（χ 2 =33.473，8.846，P＜0.001，0.003），and the group effect of ApoA was significant in both groups（χ 2 =4.889，P=0.027）．Conclusions Compared with olanzapine，the efficacy of lurasidone in the treatment of acute phase schizophrenia in women is comparable，and it has a smaller impact on metabolic indicators．
