4种非典型抗精神病药物对精神分裂症患者血糖及血脂代谢的影响

Effects on Lipid and Glucose Metabolism among Four Different Atypical Antipsychotics Agents

目的探讨4种非典型抗精神病药物利培酮、喹硫平、阿立哌唑、齐拉西酮对精神分裂症患者血糖、脂代谢的影响。方法按区组设计随机将360例精神分裂症病人分成4组，分别给予利培酮2—5mg/d、喹硫平200～600mg/d、阿立哌唑10—30mg／d和齐拉西酮120—140mg／d，治疗8周，于治疗前、后测量体重、腰围、空腹血糖（FBS）、血清胰岛素（NS）、餐后2h血糖（2hBS）、餐后2h血清胰岛素（2hNS）及空腹血脂。结果（1）治疗8周后4组病人体重和空腹血糖改变组间差异有统计学意义（P〈0．01），喹裱平对体重影响最大，而阿立哌唑对体重影响最小，阿立哌唑增加空腹胰岛素水平最明显，而喹硫平则降低空腹胰岛素水平；4种非典型抗精神病药物对腰围、血脂、血糖、胰岛素水平无明显影响；代谢综合征异常指标间无明显相关性。结论利培酮、喹硫平、阿立哌唑、齐拉西酮对精神分裂症病人的体重都有影响，而对腰围、血脂及胰岛素水平无明显影响。

Objective To estimate the effect of four atypical antipsychofics agents （risperidone,quetiapine,aripirazole,ziprasidone） on the lipid and glucose metabolism in patients with schizophrenic. Methods 360 patients with schizophrenic were divided into four groups,patients in four groups were only given fisperldone 2 -5 mg/d or quetiapine 200-600 mg/d or aripiprazole10-30 mg/d or ziprasidone 120 -140 mg/d for 8 weeks,respeefively. All patients were tested body weight,waist circumference,fasting blood glucose （FBS） and serum insulin （NS）,the 2 hours postprandial blood glucose （2hBS） and the 2 hours postprandial insulin （2hNS） and the fasting blood lipid before and after treatment. Results （1）After 8 weeks＇treatment,changes of body weight and fasting blood glucose（FBS） in four groups were significantly （P 〈0. 01 ） ; （2） quetiapine had most effect on body weight while aripiprazole the least;aripiprazole increasing FBS greatly while quefiapine decreasing FBS; the four atypical antipsychotics agents had no significant effect on waist circumference,blood lipid, glucose and serum insulin; indexes of metabolism syndrome present no significant corrdation. Conclusion Risperidone, quetiapine, aripirazole, ziprasidone has influence on body weight in patients with schizophrenic,but no effect on the waist circumference,blood lipid and serum insulin.