首次使用氯丙嗪和利培酮对精神分裂症患者血糖代谢的影响

The metabolism of blood glucose affected by chlorpromazine and risperidal in first treatment of patients with schizophrenia.

目的探讨首次使用氯丙嗪和利培酮对精神分裂症患者血糖代谢的影响。方法114例住院精神分裂症患者随机分为氯丙嗪组和利培酮组。治疗前及治疗后第1、2、3、6个月及12个月后分别测定多项血糖指标浓度,并进行对照分析。结果治疗3个月时的空腹血糖(FPG)、2小时糖耐量(2HPG)及餐后2小时血糖(2HPBG),以及治疗6个月时的糖化血红蛋白(HbA lc)浓度明显高于治疗前;治疗12个月后有15.79%的患者发生血糖调节功能受损(IGR),其中氯丙嗪组为11.65%,明显高于利培酮组6.32%;随着精神病发病年龄的增长,上述血糖浓度也逐步提高;发病年龄、疗前糖耐量及脂蛋白β浓度接近正常上限可能是IGR的诱因。结论首次使用氯丙嗪和利培酮即可影响糖代谢,应早期监测血糖,早期干预。

Objective To study the metabolism of blood glucose affected by chlorpromazine and risperidal in first treatment of patients with schizophrenia. Methods 114 schizophrenia inpatients who first use antipsychotics were randomly treated by chlorpromazine and risperidal with single medication, and were tested blood glucose at the admission, one, two, three,six months and one year after treatment respectively to contrast;Results FPG,2HPG,2HPBG,at three months and HbAic at six months after treatment were siglnificantly higher than before treatment. IGR occurred in 15.79% subjects one year after treatment. The occurrence of IGR in group chlorpromazine（ 11.65% ）was siglnificantly higher than in group risperidal（6.32% ）. With the growth age of onset of psychosis, blood glucose concentrations above-mentioned also raised gradually. Age of onset,glucose tolerance before threatment and lipoprotein B close to upper normal limit may be inducements of IGR. Conclusion Chlorpromazine and risperidal may impact the metabolism of blood glucose in first treatment, so blood glucose should be follow up initially,with PBG in particular.