摘要
目的:观察阿立哌唑、利培酮和氯氮平对精神分裂症患者糖脂代谢和体质量的影响。方法:将234例住院的精神分裂症患者随机分为3组,阿立哌唑组75例(15～25mg/d)、利培酮组78例(3～5mg/d)、氯氮平组81例(100～400mg/d)。3组均单一用药,可以适当合并苯二氮卓艹类改善睡眠。分别于治疗开始前,治疗第1、3、6个月用阳性和阴性症状量表(PANSS)评定病情,并进行空腹血糖(FBG)、餐后2h血糖(2hPBG)、甘油三酯(TG)、总胆固醇(TCH)及体质量指数(BMI)和瘦素(Leptin)测定。结果:(1)3种药物改善精神症状的整体疗效相当,PANSS评定显效率阿立哌唑组57.1%、利培酮组57.9%、氯氮平组58.1%;(2)阿立哌唑组在治疗前后BMI、糖脂代谢水平均无明显变化;利培酮组在治疗的6个月时BMI和Leptin增高[如BMI(21.78±3.41)kg/m2vs.(22.72±3.58)kg/m2,P<0.05];氯氮平组在治疗的第1、3、6个月,Leptin、BMI、FBG及血脂明显升高[如2hPBG血糖在第1、3、6个月分别增加到(8.67±2.53)mmol/L,(9.39±2.37)mmol/L,(10.16±2.87)mmol/L];(3)阿立哌唑组的BMI、2HPBG、TCH和Leptin得分均低于氯氮平组[BMI:(22.43±4.39)kg/m2vs.(24.24±6.06)kg/m2,2HPB:(7.02±1.34)mmol/Lvs.(10.16±2.87)mmol/L,TCH:(4.12±1.04)mmol/Lvs.(5.40±1.38)mmol/L,Leptin:(3.65±0.62)ng/mLvs.(5.53±0.71)ng/mL;均P<0.05]。结论:氯氮平对精神分裂症患者糖脂代谢及体质量的不良影响最大,其次是利培酮,阿立哌唑最小。
Objective： To study changes of glucose and lipid metabolism and body weight in schizophrenia patients with aripiprazle, risperidone and clozapine treatment for 6 months. Methods： Totally 234 inpatients with schizophrenia were randomly assigned to 3 treatment groups, receiving monotherapy of aripiprazle , risperidone or clozapine, respectively. A series of parameters for measuring glucose and lipid metabohsm, body mass index （ BMI ） and leptin levels were detected at baseline and after the first, third and sixth month treatment. Results： The overall curative effectives were similar in patients of the three groups （ P 〉 0. 05 ） . The response rates were 57. 1%, 57. 9%, and 58. 1% in aripiprazle group, risperidone group, and clozapine group, respectively. There was no significant difference for all indexes in aripiprazle group （ P 〉0. 05 ） . After 6 months, BMI and leptin levels in risperidone group were increased significantly compared to the baseline [ BMI： {21.78 ± 3.41} kg/m^2 vs. （22.72 ±3.58 ） kg/m^2, P 〈 0. 05 ] . During six months＇treatment, the blood glucose and lipid levels, BMI and leptin levels in clozapine group were increased significantly compared to the baseline [ 2 hour postprandial blood glucose （2hPBG） atthelst, 3rd and 6th month were （8.67±2.53） mmool/L, （9.39±2.37） mmol/L and （10.16± 2. 87） mmol/L, respectively, P 〈 0. 05 ] . BMI, 2hPBG, total cholesterol （TCH） and Leptin levels were all lower in aripiprazle group than in clozapine group [ BMI： （ 22. 43 ± 4. 39 ） kg/m^2 vs. （ 24. 24 ± 6.06 ） kg/m^2 ; 2hPBG： （7.02±1.34） mmol/L vs. （10.16±2.87） mmol/L; TCH： （4.12±1.04） mmol/L vs. （5.40± 1.38） mmool/L, Leptin levels： （3.65 ±0.62） ng/mL vs. （5.53 ±0.71） ng/mL; Ps 〈0. 05 ） ] . Conclusion： In comparison of clozapine and resperidone, apripirazle has no obvious effects during 6-month treatment, on glucose and lipid metabdism.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2009年第8期569-574,共6页
Chinese Mental Health Journal
基金
武汉市卫生局课题资助(WX08D21)
关键词
精神分裂症
糖脂代谢
体质量
瘦素
schizophrenia
glucose and lipid metabolism
mass quality
leptin
