喹硫平与舒必利治疗对精神分裂症患者血糖和脂代谢的影响

Effects of Quetiapine and Sulpiride on Serum Glucose and Lipids Metabolism in Patients with Schizophrenia

目的:探讨喹硫平与舒必利治疗对精神分裂症患者的体质量、血糖和血脂代谢的影响。方法:本研究为多中心、开放性、临床随机对照研究。对山东省精神卫生中心等5家医院的173例住院首发精神分裂症患者[分为喹硫平组(90例)和舒必利组(83例)]分别于治疗前和治疗后第4、8周末采用副反应量表进行安全性评定并测量身高体质量,次日晨抽肘静脉血测空腹血糖和血脂值。结果:(1)喹硫平组患者在治疗前后体质量、血糖、血脂值差异均无统计学意义;(2)舒必利组治疗后体质量、血糖、甘油三酯值均高于治疗前[(64.50±7.58)kg,(62.31±7.52)kg vs.(61.14±7.37)kg;(4.59±0.39)mmol/L,(4.52±0.30)mmol/L vs.(4.33±0.36)mmol/L;(1.50±0.87)mmol/L,(1.61±1.05)mmol/L vs.(0.97±0.51)mmol/L;P<0.05或0.01];(3)在治疗后第8周,舒必利组的体质量、血糖和甘油三酯值均高于喹硫平组[(61.41±7.48)kg vs.(64.50±7.58)kg,(4.24±0.30)mmol/L vs.(4.59±0.39)mmol/L,(1.08±0.79)mmol/L vs.(1.50±0.87)mmol/L;P<0.05或0.01]。结论:喹硫平对脂代谢无明显影响,而舒必利对其有明显影响。

Objective： To investigate the effects of quetiapine and sulpiride on body weight and serum glucose and lipid metabolism in patients with schizophrenia. Methods： A total of 173 inpatients with schizophrenia from 5 hospitals were randomly divided into quetiapine group （ 90 cases ） and sulpiride group （ 80 cases ） in this multicenter study. The Treatment Emergent Symptom Scale （TESS） , the fasting blood glucose and serum lipids and the body weight were measured before and after the treatment. Results： （ 1 ） There was no change in body weight, serum glucose and lipids in quetiapine group after treatment. （2） After 4-week and 8-week treatment, body weight [ （61.14 ±7.37） kg vs. （64. 50 ±7.58） kg], serum glucose level [ （4. 33 ±0. 36） mmol/L vs. （4. 59 ±0. 39） mmol/L] and triglyceride level [ （0. 97 ±0. 51 ） mmol/L vs. （ 1.50 ±0. 87） mmol/L] were significantly higher than those before treatment in sulpiride group （ Ps 〈 0. 05 ） . （ 3 ） After 8-week treatment, body weight, serum glucose and triglyceride levels in sulpiride group were significantly higher than those in quetiapine group. Conclusion： There are obvious effects on lipid metabolism after sulpiride treatment but not quetiapine.