摘要
目的评价首发精神分裂症单一使用第二代抗精神病药物治疗对体重和代谢的影响。方法采用历史性队列研究方法评估62例首发精神分裂症单一使用抗精神病药物治疗2，4周末体重和代谢改变，并且对这些患者2年后的体重和代谢情况进行随访。结果62例患者随着治疗延长，体重迅速明显增加，平均体重从基线时的（55．5±15．6）kg，第2周末增加至（56．2±15．1）kg，第4周末进一步增加至（57．3±15．0）kg。第二代抗精神病药物对体重均有影响，其中奥氮平（增加5．24％）最为突出，利培酮（增加2．6％）、喹硫平（增加2．1％）次之。治疗第4周末，部分患者的糖脂代谢出现异常。在治疗2年后共随访到47例患者，其中27例继续治疗，20例因各种原因中断治疗，其中6例患者因为体重增加而停药。持续治疗的患者中，体重全部增加，半数体重增加10％～30％，1例患者体重增加50％。结论第二代抗精神病药物在首发精神分裂症急性期治疗会影响体重和糖脂代谢，进而影响患者的躯体健康和服药依从性。
Objective To evaluate the effects of second generation antipsychotics on weight and glucose and lipid metabolism in the treatment of first--episode schizophrenia. Methods This is a historical cohort study. This 2--year survey of 62 patients on second--generation antipsychotics closely tracked weight gain and other physical and biochemical parameters. Results In the 62 patients, the weights were increased obviously and rapidly associated with second- generation antipsychotic treatment. The mean weight in baseline was（55.5±15.6）kg, which was increased to（562±15.1）kg in 2 weeks end, and increased to（57.3± 15.0）kg in 4 weeks end. Weight gain group liability was highest for olanzapine（in- creased 5.24 5）, followed by risperidone（increased 2.1 % ） and quetiapine（increased 2.6 %）. At the end of the 4 weeks, some of patients developed abnormal glucose and lipid metabolism. At the end of the 2 years, we followed up 47 patients successfully. In these 47 patients, 27 of them continued to take medication, 6 patients stopped treatment because of weight gain. In these 27 patients, all of them gained weight, half of them increased between 10% to 30%, one of them increased 50 %. Conclusions The sur vey confirms that weight gain and metabolism abnormality were also problems for Chinese schizophrenia patients treated with second--generation antipsychotics. And then the abnormality will affect the patients physical health and medication compliance.
出处
《神经疾病与精神卫生》
2013年第1期54-56,共3页
Journal of Neuroscience and Mental Health
基金
基金项目：北京大学精神卫生研究所青年科研启动基金（IMH2011-02）
关键词
抗精神病药
第二代
精神分裂症
体重
代谢
Antipsychotic agents,second--generation
Schizophrenia
Weight
Metabolism
