氯氮平、氯丙嗪对慢性精神分裂症患者血糖的影响

Clozapine and chlorpromazine affect blood glucose in patients with chronic schizophrenia

目的探讨氯氮平、氯丙嗪对慢性精神分裂症患者血糖的影响。方法对已接受长期抗精神药物治疗的慢性精神分裂症患者,继续服用氯氮平(43例,氯氮平组),氯丙嗪(32例,氯丙嗪组)后的不同时点进行空腹血糖(FBG)及餐后2h血糖(2hBG)测定。结果使用氯氮平、氯丙嗪治疗3个月末空腹血糖及餐后2h血糖无明显增高(P>0.05);治疗6、12个月末空腹血糖及餐后2h血糖均增高,与基础值比较差异有高度显著性(P<0.01),两组治疗6、12个月末差异有显著性(P<0.05或0.01)。氯氮平组空腹血糖和餐后2h血糖异常(空腹血浆血糖≥7.0 mmol/L,餐后2h血浆血糖≥11.1 mmol/L)的发生率较氯丙嗪组高,但两组治疗12个月末仅餐后2h血糖差异有显著性(P<0.05)。结论氯氮平和氯丙嗪均影响慢性精神分裂症患者的血糖代谢,氯氮平较明显。

Objective To investigate the effects of clozapine and chlorpromazine on blood glucose （BG） in patients with chronic schizophrenia. Methods After receiving long- term antipsychotic treatment, patients continued to use oral clozapine （clozapine group, n = 43） and chlorpromazine （chlorpromazine group, n = 32） were involved in this study. The fasting blood glucose （FBG） and 2h- blood glucose after meals （2hBG） were measured at different time points. The statistical analysis was performed. Results At the end of 3 months after receiving continuous clozapine and chlorpromazine treatment, no elevated FBG and 2hBG were found in both groups, compared to baseline values, there were no statistical differences （ P 〉0.05）. But 6 months or 12 months after the treatment, FBG and 2hBG were elevated in both groups, compared to baseline values, there were statistical significant differences （ P 〈 0.01）. In comparison of FBG and 2hBG between clozapine group and chlorpromazine group, there were statistical differences （ P 〈 0.05 or 0.01） at the end of 6 -month or 12 -month treatment. The incidences of abnormal FBG and 2hBG （FBG≥7.0mmol/L, 2hBG≥11. lmmol/L） in clozapine group were higher than those in chlorpromazine group, there was statistical difference （ P 〈 0.05 ） between clozapine group and chlorpromazine group in comparison of 2hBG at the end of 12 - month treatment. Conclusion Clozapine and chlorpromazine can. affect BG metabolism of patients with chronic schizophrenia, and clozapine even more obviously.