摘要
目的探讨长期服用二甲双胍对精神分裂症合并代谢综合征患者糖脂代谢影响以及安全性分析。方法将120例精神分裂症合并代谢综合征患者随机分为研究组和对照组各60例,两组患者均给予奥氮平治疗,研究组合并二甲双胍治疗,对照组合并等剂量安慰剂,治疗时间4个月。治疗前及治疗后第4个月末,采用阳性和阴性综合征量表(PANSS)评价临床疗效,检测患者肝肾功能、糖脂代谢指标、血清炎性因子以及肝脏脂肪含量等指标,比较两组患者治疗期间发生低血糖、乳酸酸中毒、恶心、腹泻、肝肾功能损伤、恶性心律失常、锥体外系反应等发生率差异。结果治疗后研究组患者FBG、餐后2 h血糖、Hb A1C、HOMA-IR、TC、LDL、肝脂肪含量、体质量指数、腰臀围比例、血清CRP、瘦素水平均较治疗前降低(P<0.05),脂联素水平较治疗前升高(P<0.05)。治疗后对照组FBG、餐后2 h血糖、Hb A1C、HOMA-IR、TC均较治疗前降低(P<0.05),LDL、肝脂肪含量、体质量指数、腰臀围比例较治疗前升高(P<0.05)。治疗后研究组患者FBG、餐后2 h血糖、Hb A1C、HOMA-IR、TC、LDL、肝脂肪含量、体质量指数、腰臀围比例、血清CRP、瘦素水平均低于对照组(P<0.05),脂联素水平高于对照组(P<0.05)。两组患者临床疗效及不良反应发生率比较差异均无统计学意义(P>0.05)。结论二甲双胍可有效、安全地改善精神分裂症合并代谢综合征患者的代谢异常。
Objective To explore the effects and safety of metformin to improve glucose and lipid metabolism in schizophrenic patients with metabolic syndrome. Methods A total of 120 schizophrenic patients with metabolic syndrome were randomly divided into study group（ n = 60） with olanzapine combined with metformin and control group（ n = 60） with olanzapine for 4 months of treatment. They were assessed with Positive and Negative Syndrome Scale （PANSS）, examined for the liver and kidney function, glycometabolism index, serum inflammatory and liver fat content and compared with the incidence rates of hypoglycemia, lactic acidosis, nausea, diarrhea, liver and kidney dysfunction, malignant arrhythmia and extrapyramidal side effects before and after treatment. Results In study group, the levels of fasting blood glucose （ FBG）, postprandial 2 h blood glucose, glycosylated hemoglobin （HbA1C）, insulin resistance index （HOMA-IR）, total cholesterol, low density lipoprotein （LDL）, liver fat content, body mass index （BMI）, waist circumference, serum CRP and leptin after treatment were all significantly lower than those before treatment （ P 〈 0.05 ）, and the level of adiponectin after treatment was significantly higher than that before treatment（P 〈 0.05 ）. In control group, the levels of FBG, postprandial 2 h blood glucose, HbA1 C, HOMA-IR and total cholesterol were all significantly lower than those before treatment（ P 〈 0.05 ） , and the levels of LDL, liver fat content, BMI and waist circumference were significantly higher than those before treatment （ P 〈 0. 05 ）. After treatment, the levels of FBG, postprandial 2 h blood glucose, HbA1C, HOMA-IR, TC, LDL, liver fat content, BMI, waist circumference, serum CRP and leptin in study group were all significantly lower than those in control group（ P 〈 0.05 ）, and the adiponectin level in study group was significantly higher than that in control group （ P 〈 0.05 ）. There were no differences for the clinical efficacy and incidence rate of side effects between two groups after treatment （P 〉 0.05 ）. Conclusion It＇s effective and safe for metformin to improve glucose and lipid metabolism in schizophrenic patients with metabolic syndrome.
作者
韩攸村
贾继敏
黄同旭
张铮
王福华
HAN Youcun JIA Jimin HUANG Tongxu et al(Binzhou Privilege Hospital, Binzhou 256600, Chin)
出处
《精神医学杂志》
2016年第6期443-447,共5页
Journal of Psychiatry
