| Objective: To compare the effects of olanzapine and perphenazine on blood pressure and heart rate of elderly schizophrenics.Methods:From October 2018 to September 2019,altogether 66 patients,were enrolled in a psychiatric hospital in Fujian Province.They were randomly divided into olanzapine group and perphenazine group with 33 patients in each group.In olanzapine group,there were 10 males(30.30%)and 23 females(69.70%);the age was 70.30 ± 9.28 years old;the patients took 10-15 mg olanzapine per day for two weeks.In perphenazine group,there were 9 males(27.30%)and 24 females(72.70%);age 72.30 ± 5.16 years old,were treated with perphenazine 10-20 mg per day for two weeks.Patients in the two groups were monitored for 24-hour ambulatory blood pressure and heart rate before and after treatment for two weeks to obtain baseline data and post-treatment data.Results:1.There was no significant difference in baseline blood pressure(systolic pressure,SBP 121.79 ± 12.09 mm Hg VS.126.16 ± 14.81 mm Hg,t=-1.315,P > 0.05;diastolic pressure,DBP 72.47 ± 6.59 mm Hg VS.74.55 ± 10.62 mm Hg,t=-0.954,P > 0.05)and heart rate(76.27 ± 11.33 次/分 VS.77.94 ± 11.46 次/分,t=-0.594,P > 0.05).2.There was no significant difference in post-treatment blood pressure(systolic blood pressure 119.03 ± 12.85 mm Hg VS.124.87 ± 15.77 mmhg,F= 1.285,P > 0.05;diastolic blood pressure: 71.79 ± 6.31 mmhg VS.71.77 ± 9.53 mm Hg,F= 0.736,P >0.05)and heart rate(73.73 ± 10.91 beats / min VS.75.79 ± 11.58 beats / min,F=0.556,P > 0.05)after treatment.3.After two weeks of drug treatment,compared with baseline data,24 h DBP(74.55 ±10.62 mm Hg VS.71.77 ± 9.53 mm Hg,t=2.118,P < 0.05)of the patients in the Perphenazine group decreased significantly.There was no significant difference in SBP(126.16 ± 14.81 mm Hg VS.124.87 ± 15.77 mm Hg,t=0.444,P > 0.05)of perphenazine group.So were the SBP(121.79 ± 12.09 mm Hg VS.119.03 ± 12.85 mm Hg,t=1.414,P > 0.05)and DBP(72.47 ± 6.59 mm Hg VS.71.79 ± 6.31 mm Hg,t=0.628,P > 0.05)of the patients in the Olanzapine group.4.After two weeks of drug treatment,the trough to peak ratio(T/P)(72.11 ± 8.87 VS.68.71 ± 7.31,t=2.201,P < 0.05)of SBP decreased in the Olanzapine group while these patients’ T / P(60.57 ± 7.64 VS.71.74 ± 6.57,t=-7.389,P < 0.001)of DBP increased significantly.Whereas there was no statistical difference in T / P(SBP 69.07 ± 7.35 VS.67.49 ± 8.91,t=0.959,P > 0.05;DBP 63.17 ± 10.13 VS.62.93 ± 10.39,t=0.113,P > 0.05)of patients in the Perphenazine group.5.After two weeks of drug treatment,the changes of Coefficient of Variation(CV),were as follows: in the Perphenazine group,the d SBP-CV increased(8.62 ± 2.75 VS.10.02 ± 3.55,t=-2.156,P < 0.05);in the Olanzapine group,the d SBP-CV also increased(8.06 ± 3.52 VS.9.37 ± 2.67,t=-2.086,P < 0.05)while the d DBP-CV and n DBP-CV decreased significantly(13.05 ± 3.32 VS.8.83 ± 2.45,t=6.999,P < 0.001;12.20 ± 3.38 VS.8.68 ± 2.77,t=5.264,P < 0.001)and the 24 h DBP-CV also decreased significantly(12.66 ± 4.83 VS.7.67 ± 3.69,t=5.461,P < 0.001).6.After two weeks of treatment,the T/P of diastolic blood pressure in olanzapine group(71.74 ± 6.57 VS.62.93 ± 10.39,F= 20.162,P < 0.001)was significantly higher than that of perphenazine group,and the CV(8.83 ± 2.45 VS.12.18 ± 4.33,F=16.225,P < 0.001)in olanzapine group was significantly lower than that in perphenazine group.7.After two weeks of drug treatment,there was no significant difference in heart rate between the two groups(olanzapine group 76.27 ± 11.33 times / min VS.73.73 ±10.91 times / min,t=0.908,P > 0.05;perphenazine group 77.94 ± 11.46 times / min VS.75.79 ± 11.58 times / min,t=0.763,P > 0.05).8.After two weeks of drug treatment,there was significant difference in QTc(corrected QT interval)interval of olanzapine group(439.45 ± 15.687 VS.428.91 ±21.075,t=2.892,P < 0.05)and perphenazine group(436.18 ± 18.443 VS.422.39 ±16.970,t=4.141,P < 0.001).9.There was statistically significant difference in serum potassium concentration of olanzapine group(3.94 ± 0.34 mmol/L VS.4.24 ± 0.26 mmol/L,t=-4.241,P < 0.001)and perphenazine group(3.97 ± 0.30 mmol/L VS.4.22 ± 0.35 mmol/L,t=-2.961,P <0.05)before and after treatment.10.After two weeks of drug treatment,the treatment inefficiency(PANSS reduction rate < 25%)of olanzapine group was 0;the improvement rate(50% > PANSS reduction rate ≥ 25%)was 81.8%;the significant improvement rate(75% > PANSS reduction rate ≥ 50%)was 9.1%;the clinical cure rate(PANSS reduction rate ≥75%)was 9.1%.In perphenazine group,the invalid rate was 6.1%,the improvement rate was 72.7%,the significant improvement rate was 15.1%,and the clinical cure rate was 6.1%.There was no significant difference between the two groups(μ =-0.263,P > 0.05)Conclusion:1.Perphenazine reduces diastolic blood pressure of the elderly schizophrenics.2.Both olanzapine and olanzapine decreased the systolic stability in elderly schizophrenics.3.Compared with perphenazine,olanzapine has less side effects on diastolic blood pressure stability in the treatment of the elderly schizophrenics.4.Increase the serum potassium concentration appropriately,olanzapine or perphenazine has no effect on the heart rate of elderly patients with schizophrenia,but can shorten QTc.5.Olanzapine or perphenazine are effective in the early treatment of senile schizophrenia. |
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