摘要
目的研究4种抗精神病药对糖代谢、脂代谢的不良影响。方法112例精神分裂症患者根据临床治疗需要分为氯氮平组(30例)、奥氮平组(24例)、利培酮组(29例)和舒必利组(29例),均治疗观察4周。每组患者于治疗前后测空腹血糖、甘油三酯、胆固醇、胰岛素、C肽,量身高、体质量、腰围、臀围,并计算体质量指数(BMI)及胰岛素抵抗指数(IR)。结果(1)治疗后4组患者的空腹胰岛素、C肽及IR均升高,与治疗前的差异有统计学意义(P<0.05);治疗后氯氮平组和奥氮平组患者的甘油三酯及胆固醇均明显高于治疗前(P<0.05)。(2)治疗后BMI的升高程度为:氯氮平>奥氮平>舒必利>利培酮,差异均有统计学意义(P<0.05)。空腹胰岛素、C肽、甘油三酯、胆固醇及IR的升高程度为:氯氮平和奥氮平>舒必利和利培酮,差异均有统计学意义(P<0.05)。(3)氯氮平组、奥氮平组的甘油三酯及IR升高程度均为男性大于女性,胆固醇升高程度为女性大于男性;舒必利组的变化则相反。结论氯氮平和奥氮平对糖代谢及脂代谢的影响大于利培酮和舒必利,并存在性别差异。
Objective To study the side-effects of four antipsychotic drugs on the glucose metabolism and lipid metabolism in schizophrenic patients. Methods One hundred and twelve schizophrenic patients were divided into clozapine group, olanzapine group, risperidone group and sulpiride group. Before and after four-week treatment, the height, body weight waist circumference, hip circumference, and the fasting blood glucose, insulin, C-peptide, cholesterol and triglyceride were measured. In addition, the body mass index （BMI） and insulin resistance （IR） were calculated. Results After treatment, the serum insulin, C-peptide and IR levels increased significantly in four groups. The cholesterol and triglyceride concentrations significantly increased in clozapine and olanzapine groups. The increased level of BMI was clozapine 〉 olanzapine 〉 risperidone 〉 sulpiride and the increased level of the insulin, C-peptide,cholesterol, triglyceride and IR was clozapine = olanzapine 〉 risperidone = sulpiride. In clozapine and olanzapine groups, the increased level of triglyceride and IR was significantly higher in male than female,but the increased level of cholesterol was significantly higher in female than male. However, there was opposite changes in sulpiride group. Conclusion Clozapine and olanzapine have more severe side-effects on the glucose metabolism and lipid metabolism than risperidone and sulpiride with gender difference.
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2005年第3期130-133,共4页
Chinese Journal of Psychiatry
基金
"十五"国家科技攻关项目(2004BA720A22)
