碳酸锂合并奥氮平及碳酸锂单独治疗双相情感障碍期间血脂水平和体重变化

Changes of lipid levels and body weight during the treatment of bipolar disorder by lithium carbonate combined with olanzapine or lithium

目的探讨碳酸锂合并奥氮平与碳酸锂单独治疗双相情感障碍期间患者血脂水平和体重变化。方法测定46例双相情感障碍患者采用碳酸锂合并奥氮平治疗6个月（一期）、之后再单独使用碳酸锂治疗6个月（二期）结束时的体重、血脂，并与治疗前进行比较。结果一期治疗结束时患者总胆固醇、三酰甘油、载脂蛋白B水平增高（P〈0．05）；二期治疗结束时总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B水平进一步增高（P〈0．05），其中总胆固醇、三酰甘油和LDL-C超过正常水平，载脂蛋白虽增高，但未超过正常水平。一期治疗结束时患者体重为（68．70±8．35）kg，显著高于治疗前的（64．85±7．52）kg（P〈0．05），二期治疗结束时患者体重为（71．72±7：96）kg，与一期治疗结束时比较差异有统计学意义（P〈0．05）。男女性别分开统计后仍符合以上特点。结论碳酸锂合并奥氮平及碳酸锂单独治疗双相情感障碍期间均可导致患者的体重和血脂水平增高，以碳酸锂单独治疗期间血脂改变明显，增加了患冠心病的危险性。

Objective To study the changes of lipid levels and body weight during the treatment of bipolar disorder by lithitim carbonate combined with olanzapine or lithium. Methods Lipid and body weight was measured in forty-six patients with bipolar disorder in the first six months （treated by lithium carbonate combined with olanzapine） and in the second six months （treated by lithium only）. Then the results were compared with the data before the treatment. Results When the first six months was over,the levels, of the total cholesterol, triglyceride and apolipoprotein B increased（P 〈 0.05 ）, and when the second six months was over,the levels of the total cholesterol,triglyceride,low density lipoprotein cholesterol （LDL-C）,and apolipoprotein B increased Significantly （P 〈 0.05）, The levels of the total cholesterol,triglyceride,LDL-C were more than the normal level,but apolipoprotein B didn＇t exceed the normal level. When the first six months was over,the body weight was higher than that before treatment [（68.70 ± 8.35） kg vs. （64.85 ± 7.52） kg, P 〈 0.05 ]. Whenthe second six moiaths was over, the body weight [ （71.72 ± 7.96） kg ] was higher than that at the end of the first six months （P 〈 0.05 ）. Gender difference showed non-statistical significance. Conclusions The lipid levels and body weight will both in＇crease whether treated with lithium carbonate combined with olanzapine or with lithium only. The lipid level changes apparently in treatment with lithium separately, and the risk of coronary heart disease will increase.