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目的：探讨奥氮平治疗脑血管病所致精神障碍患者的疗效和安全性。方法对110例脑血管病所致精神障碍患者在脑血管病常规治疗的基础上口服奥氮平治疗，观察6周。采用阳性与阴性症状量表评定疗效，副反应量表评定不良反应。结果入组患者治疗2周末起，阳性与阴性症状量表偏执及妄想观念、幻觉、行为紊乱、日夜节律紊乱因子评分均较治疗前显著下降（ P＜0.01）；治疗后不良反应发生率较低，程度较轻微，主要表现为体质量增加、高血糖、嗜睡、窦性心动过速、口干、便秘、步态异常等。结论奥氮平治疗脑血管病所致精神障碍疗效显著，安全性高，依从性好。“,”Objective To explore the efficacy and safety of olanzapine in the treatment of mental disorders due to cerebrovascular diseases (MDCD) .Methods A total of 110 MDCD patients took orally olanzapine for 6 weeks on the basis of conventional therapy for cerebrovascular diseases .Efficacies were assessed with Positive and Negative Syndrome Scale (PANSS ) and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results Since the 2nd week their paranoia ,delusional idea ,hallucinations ,cha‐otic behavior and circadian rhythmdisturbance score on the PANSS lowered more significantly compared with pretreatment (P<0.01);the incidence of adverse reactions was lower and severity mild ,adverse re‐actions were mainly weight gain ,hyperglycemia ,hypersomnia ,sinus tachycardia ,dry mouth/constipa‐tion ,gait abnormal and so on .Conclusion Olanzapine has an evident effect ,higher safety and better compliance in the treatment of mental disorders due to cerebrovascular disease .