氯氮平、利培酮、氯丙嗪对糖代谢影响的对照研究

A Comparative Study of the Effects of Clozapine,Risperidone and Chlorpromazine on Sugar Metabolism in Schizophrenic Treatment

目的比较氯氮平、利培酮、氯丙嗪对精神分裂症患者糖代谢影响的差异。方法120例首发精神分裂症患者,随机分为3组,分别接受氯氮平(氯氮平组)、利培酮(利培酮组)及氯丙嗪(氯丙嗪组)治疗,疗程6周。检测治疗前、治疗后6周空腹血糖(FPG)、糖耐量试验2小时血糖值(2HPG)。结果1组内比较,治疗前、后FPG无显著差异(P>0.05);治疗后2HPG高于治疗前(分别P<0.001,P<0.05);2组间比较,氯氮平组治疗后2HPG[(7.88±1.11)mmol/L],高于氯丙嗪组[(7.32±0.98)mmol/L]及利培酮组[(7.29±1.04)mmol/L](均P<0.05),而后两组间无显著差异(P>0.05)。结论氯氮平、利培酮、氯丙嗪对糖代谢的影响以2HPG为主,且氯氮平的影响大于利培酮及氯丙嗪。

Objective To compare how clozapine, risperidone and chlorpromazine affect sugar metabolism in schizophrenic treatment. Methods 120 first episode Schizophrenias were randomly divided into three groups which treated with clozapine, risperidone and chlorpromazine respectively for 6 weeks. The fasting plasma glucose （FPG） and 2-hour plasma glucose tolerance test （2HPG） were measured as the baseline and after the treatment. Results No significant difference between scores of baseline and that after the treatment in the FPG was found in the three groups （P〉0. 05）, while the 2HPG after treatment were significantly higher than those at baseline （P〈0. 001, P〈0. 05; The 2HPG after treatment was higher in clozapine [（7.88±11.11）mmol/L] than that in chlorpromazine [（7. 32±0. 98）mmol/L] and risperidone [（7.29±1.04）mmol/L] （P〉0. 05）. There is no obvious difference between the 2HPG of risperidone and chlorpromazine after the treatment （P〉0. 05）. Conclusion Each of the medications, clozapine, risperidone and chlorpromazine affects the sugar metabolism, mainly in the 2HPG;Clozapine has stronger effects on sugar metabolism than risperidone and chlorpromazine.