抗精神病药物对精神分裂症患者血脂、血糖和体重影响的研究

Effects of antipsychotic drugs on blood lipid and blood glucose and body weight in schizophrenia

目的比较精神分裂症患者服用抗精神病药物后血脂、血糖及体重的变化,评价不同药物的安全性。方法选择109例单一应用抗精神病药物治疗满8周的精神分裂症患者,分别于第4周、第8周测量血脂(胆固醇、甘油三脂)、血糖和体重。结果服用抗精神病药物后女性、高龄患者甘油三脂增高显著,差异有统计学意义(t=-2.34,P<0.05;r=0.256,P=0.007);氯氮平对胆固醇升高影响显著高于利培酮、奎硫平、氯丙嗪、奋乃静等(P<0.05);氯氮平、氯丙嗪对甘油三脂升高影响显著高于利培酮(P<0·05);所有纳入研究的药物对血糖、体重有不同程度影响,差异无显著性(P>0.05)。结论大多数抗精神病药物可增加高血脂、肥胖的风险,选择药物应考虑性别及年龄因素。

Objective To explore the effects of antipsychotic drugs on blood lipid, blood glucose and body weight in schizophrenics,and to assess the safety of different antipsychotic drugs. Methods One hundred and nine schizophrenics treated with only one of antipsychotic drugs at least 8-week were selected. After 4-week and 8-week treatment,the blood lipid and blood glucose and body weight were measured. Results After 8-week treatment, the blood triglyceride level was increased in female（t=-2.34, P〈0.05）and elderly patients（r= 0.256, P=0. 007）. After 4 weeks, the blood cholesterol levels were significantly increased（P〈0.05）for patients with clozapine compared with risperidone, seroquel, chlorpromazine and perphenazine; clozapine and chlorpromazine caused a marked increase（P〈0.05）in serum triglyceride than risperidone. The changes of body weight and blood glucose were not significantly different in the varied antipsychotic drugs（P〉0.05）. Conclusion The results suggest that weight gain and lipid abnormalities are common adverse effects associated with the use of most antipsychotic drugs. More attention should be paid to female and elderly patients in antipsychotic drug selection.