阿立哌唑在治疗抗精神病药物所致糖尿病13例的安全性研究

Aripiprazole in the treatment of schizophrenia with diabetes caused by antipsychotic drugs of the safety study

目的：评估阿立哌唑在抗精神病药物所致的糖尿病精神分裂症治疗中的风险。方法：将抗精神病药物所致的糖尿病27例精神分裂症患者随机分为两组,阿立哌唑＋降糖药物组、氟哌啶醇＋降糖药物组,治疗观察期均为12个月。两组患者均在入组治疗前进行1～2月的药物调整,调整后血糖（OGTT、FBG）仍异常者,并且符合1990年中国糖尿病学会诊断标准者。入组后每月末测定空腹血糖、身高、体重、腰围、计算体质量指数（BM I）并进行比较。结果：阿立哌唑＋降糖药物组和氟哌啶醇＋降糖药物组患者治疗后的空腹血糖、体质量、腰围、体重均低于治疗前（P〈0.05）,阿立哌唑组空腹血糖、体质量、腰围、体重各项减分率明显大于氟哌啶醇组,降糖药物平均剂量也低于氟哌啶醇组,没有出现因血糖升高而终止治疗者,阿立哌唑组的生活质量和依从性优于氟哌啶醇组。结论：阿立哌唑＋降糖药物与氟哌啶醇＋降糖药物均能有效减轻抗精神药物所致糖尿病病情,阿立哌唑＋降糖药物的疗效优于氟哌啶醇＋降糖药物组。氟哌啶醇＋降糖药物仍不失有效的治疗方法,但在这部分患者治疗中有出现血糖升高现象,需要对血糖严格监测和及时调整治疗方案。

Objective：Aripiprazole in the treatment of schizophrenia with diabetes caused by antipsychotic drugs of the safety study. Methods：27 cases of schizophrenia patients with diabetes caused by antipsychotics were randomly divided into two groups,aripiprazole and hypoglycemic drug group,haloperidol and hypoglycemic drug group,treatment observation period were 12 months.Both of the groups were enrolled in 1-2 months before the drugs readjusted,the glucose（OGTT,FBG） is abnormal,and in line with the 1990 China Diabetes Association diagnostic standards.The fasting blood glucose,height,weight,waist circumference,body mass index（BMI） will be calculate and compared at the end of every month after income group.Results： The fasting blood glucose,body mass,waist circumference,body weight are lower than before in both the two groups（P〈0.05）.The fasting blood glucose,body weight,waist circumference,body weight by the sub-group of aripiprazole group was significantly greater than haloperidol group and the average dose of hypoglycemic drugs also lower than the haloperidol group.Treatment termination did not appear because of increased blood glucose.Conclusions： Both of the groups can effectively reduce the condition of diabetes caused by antipsychotics,and the effect of aripiprazole group is superior to haloperidol group.Haloperidol and hypoglycemic drugs is still an effective method of treatment,but in some patients the blood glucose was emerged,so the strict monitoring of blood glucose and timely adjust will be need.