第2代抗精神病药对代谢的影响

The effect of second degeneration antipsychotics on metabolism

目的:探讨奥氮平、奎硫平和齐拉西酮对首发精神分裂症患者血脂和体质量的影响。方法:选择住院治疗的首发精神分裂症患者114例,随机分为奥氮平组35例、奎硫平组41例、齐拉西酮组38例。治疗前、治疗4周和治疗8周检测血脂水平和体质量。结果:奥氮平组治疗4周、治疗8周总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL)和体质量均较治疗前显著升高(P<0.05);高密度脂蛋白胆固醇(HDL)水平显著降低(P<0.05);奎硫平组至治疗8周时,TC、TG、低密度脂蛋白胆固醇(LDL)和体质量均较治疗前显著升高(P<0.05);而齐拉西酮组治疗4周和治疗8周与治疗前比较,TC、TG、HDL、LDL、体质量水平差异均无显著性。在治疗8周奥氮平组、奎硫平组TC、TG、HDL、LDL、体质量变化与齐拉西酮组比较差异有显著性(P<0.05)。结论:齐拉西酮对精神分裂症患者血脂和体质量的影响较奥氮平、奎硫平小,奥氮平和奎硫平在精神分裂症治疗过程中均可导致血脂异常和体质量增加。

Objective：To study the effects of ,olanzapine, quetiapine and ziprasidone on blood lipometabolism and body weight of first-episode schizophrenia, nethod：A total of 114 first-episode schizophrenia patients are randomly divided into olanzapine group（ n = 36 ） , quetiapine group （ n = 41 ） and ziprasidone group （n = 38 ）. The lipometabolism level and weight were measured before treatment and at the end of 4 weeks and 8 weeks treatment. Results：Total cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDL） level and weight gain of olanzapine group significantly increased after 4 weeks and 8 weeks treatment （ P 〈 0.05 ）, while high density lipoprotein（HDL） level significantly decreased（ P 〈0. 05 ）. The TC, TG, LDL and weight gain of quetiapine group significantly increased at the end of 8 weeks treatment. However,TC,TG, HDL, LDL level and weight gain of ziprasidone group have no significant difference after 4 weeks and 8 weeks treatment. TC, TG, HDL. LDL. level and weight gain in ziprasidone group had significant difference form both olanzapine group and quetiapine group after 8 weeks treatment（ P 〈0.05 ）. Conclusion：Ziprasidone has lower effect on blood lipometabolism and weight of first-episode schizophrenia than olanzapine and quetiapine. The latter two can cause the blood lipometabolism disorder and weight gain during the treatment.