阿立哌唑与奥氮平对首发精神分裂症患者糖脂代谢的影响

Effects of aripiprazole versus olanzapine on glucose and lipid metabolism in first-episode schizophrenics

目的探讨阿立哌唑与奥氮平对首发精神分裂症患者糖脂代谢的影响。方法将101例首发精神分裂症患者随机分为两组，研究组50例，口服阿立哌唑治疗，对照组51例，口服奥氮平治疗，观察8周。于治疗前及治疗8周末采用阳性与阴性症状量表评定临床疗效，同时检测两组血糖、血脂水平及体质量。结果治疗8周末，两组阳性与阴性症状量表总分减分值差异无显著性（t=0．63，P〉0．05）；研究组胆固醇、低密度脂蛋白、空腹血糖、空腹胰岛素、胰岛素抵抗指数均显著低于对照组（P〈0．01）；研究组体质量增加〉7．0％者占14．0％，对照组为52．9％，研究组显著低于对照组（χ^2=17．14，P〈0．01）。结论阿立哌唑与奥氮平均能显著改善精神分裂症患者的各种精神症状，但奥氮平对患者的血糖、血脂代谢及体质量有显著影响，而阿立哌唑则无明显影响。

Objective To explore the effects of aripiprazole versus olanzapine on glucose and lipid metabo- lism in first-episode schizophrenics. Methods 101 first-episode schizophrenics were randomly assigned to research group （n=50） taking orally aripiprazole and control group （n = 51） did olanzapine for 8 weeks. Clinical efficacies were assessed with the Positive and Negative Syndrome Scale （PANSS） before treatment and at the end of the 8th week and blood glucose, blood fat and body mass detected simultaneously. Results At the end of the 8th week there was no significant difference in the decrement of the PANSS total score be- tween two groups （t=0.63,P〉0.05）; cholesterol, LDL, fasting blood glucose, fasting insulin and insu- lin resistance index were all significantly lower research than in control group （P〈0.01） ; patients with 7.0%of weight gain were significantly fewer in research than in control group （14.0% vs. 52.9%,χ^2= 17.14,P〈0.01） . Conclusion Both aripiprazole and olanzapine could improve various kinds of symptoms of schizophrenics, but the latter has notable effects on blood glucose, lipid metabolism and body mass, the former has no.