氯氮平对长期住院精神分裂症患者糖代谢的影响

Effects of Clozapine on glucose metabolism in chronic schizophrenic inpatients

目的调查氯氮平对长期住院的精神分裂症患者糖代谢的影响。方法根据空腹静脉和餐后2 h静脉血糖水平,对服用氯氮平的长期住院男性精神分裂症患者进行糖尿病及与糖尿病相关状态的诊断。结果 67例患者中20例患者有糖尿病(29.8%),16例有糖耐量减低(IGT)(23.9%),6例有空腹血糖损害(IFG)(9%),25例为血糖代谢正常者(37.3%)。根据氯氮平剂量、体质指数和服药时间的不同将患者各分成3组,3组间的糖代谢异常发生率差异无统计学意义。正常组、IFG组、IGT组以及糖尿病组患者在胆固醇水平、体质指数、氯氮平剂量、三酯甘油水平以及服药时间之间差异无统计学意义。在IFG组,体质指数与患者每天氯氮平服用剂量之间呈显著性正相关(r=0.889,P=0.019),而在IGT组,各临床资料之间无明显相关性。结论长期服用氯氮平对精神分裂症患者糖代谢有明显影响。

Objective To explore the glucose metabolism in chronic schizophrenic inpatients by Clozapine treatment.Methods Accordingto the blood glucose level of fasting and glucose level after food intake 2 hours,the patients were diagnosed diabetes mellitus,impaired fasting glucose（IFG） and impaired glucose tolerance（IGT）.Results Among 67 schizophrenic patients,20 cases（29.8%） were diabetes mellitus,16 cases（23.9%） were IGT,6 cases（9%） were IFG and 25 cases（37.3%） were normal in glucose metabolism.The rates of glucose metabolic conditions were not different among the three different subgroups when the patients were divided into three subgroups basedon the duration of Clozapine treatment,dose of Clozapine,and body mass index（BMI）.There were not different in the level of cholesterol and triglyceride,the BMI and dose of Clozapine among the different groups of glucose metabolic conditions.In IFG group,the BMI and dose of Clozapine were significantly positive correlation（r=0.889,P=0.019）.Conclusion The effects of Clozapine on glucose metabolism in chronic schizophrenic inpatients were significantly obvious.