非经典抗精神病药对代谢的影响

Influences on metabolism for patients with first-episode schizophrenia treated with atypical antipsychotics

目的:探讨非经典抗精神病药对精神分裂症患者血糖、糖化血红蛋白(HbA1C)、三酰甘油(TG)、高密度脂蛋白(HDL)和体质量的影响。方法:将176例精神分裂症患者分成氯氮平组(30例)、奥氮平组(30例)、奎硫平组(30例)、利培酮组(30例)、阿立哌唑组(30例)和齐拉西酮组(26例),治疗6周。于治疗前和治疗6周测量空腹血糖、HbA1C、TG、HDL和体质量。结果:治疗前后血糖、HbA1C、TG、HDL和体质量在阿立哌唑组和齐拉西酮组无显著变化,氯氮平组和奥氮平组治疗后显著增高(P<0.05或P<0.01);奎硫平组和利培酮组可引起体质量显著增加(P<0.01),但对血糖、HbA1C、TG、HDL影响不大。结论:阿立哌唑、齐拉西酮对精神分裂症患者代谢的影响较小,奎硫平、利培酮次之,氯氮平、奥氮平对患者代谢的影响最大。

Objective：To explore the influences on blood glucose,glycohemoglobin,triglyceride,high density lipoproteins and body weight for patients with first-episode schizophrenia treated with atypical antipsy-chotics. Method：176 patients with first-episode schizophrenia were divided into clozapine group,olanzapine group,quetiapine group,risperidone group,aripiprazole group and ziprasidone group for 6 weeks treatment. The blood glucose,glycohemoglobin,triglyceride,high density lipoproteins and body weight were measured before and after 6 weeks treatment. Results：There were no significant changes in the level of blood glucose,glycohemo-globin,triglyceride,high density lipoproteins and body weigh for patients in aripiprazole group and ziprasidone group after 6 weeks treatment,however,all index above statistically increased in patients of clozapine group and olanzapine group compared with those in aripiprazole group and ziprasidone group（ P 0. 05 or P 0. 01）. Body weight had markedly increased for patients in quetiapine group and risperidone group after 6 weeks treatment（ P 0. 01） ,however,no statistical differences were found on blood glucose,glycohemoglobin,triglyceride and high density lipoproteins in them. Conclusion：Aripiprazole and ziprasidone may have less effect on metabolism for patients with schizophrenia. Quetiapine and risperidone can induce to increase body weight,but they may have little effect on metabolism of blood glucose and fat. Clozapine and olanzapine may have more effect on metabolism for patients with schizophrenia.