齐拉西酮替代奥氮平对精神分裂症伴发代谢综合征患者的影响

The Influence to Patients with Schizophrenia Associated with Metabolic Syndrome by Using Zipasidone Instead of Olanzapine

目的探讨服用奥氮平伴发代谢综合征的精神分裂症患者换用齐拉西酮后代谢指标的变化及临床疗效。方法将108例服用奥氮平治疗,病情稳定(PANSS总分<60分),同时符合代谢综合征诊断标准的精神分裂症患者,随机分为换药组(研究组)与维持治疗组(对照组)各54例,研究组2周内将奥氮平换成齐拉西酮,并继续服用10周,对照组维持奥氮平治疗。分别于治疗前、6周后、12周后测量腰围、收缩压、舒张压、体重指数(BMI)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、空腹血糖(FBG),同时采用阳性与阴性症状量表(PANSS)评定疗效、副反应量表(TESS)评定药物不良反应。结果治疗6周后,研究组腰围、收缩压、BMI、TG均显著低于对照组(P<0.05),12周后上述指标持续下降(P<0.001),FBG也出现下降,差异有显著性(P<0.05),两组PANSS及TESS评分6周、12周后均无显著差异(P>0.05)。结论用齐拉西酮替代奥氮平,是改善奥氮平伴发代谢综合征患者代谢指标的一个有效对策。

Objective To explore the clinical efficacy and changes of metabolic index by using Zipasidone instead of Olanzapine to patients with schizophrenia associated with metabolic syndrome.Methods A total of 108 patients with schizophrenia taking Olanzapine,in the stable condition and conforming to the diagnostic standard of MS were randomly assigned to study group（n=54）and control group（n=54）.To choose Ziprasidone instead of Olanzapine in study group within 2 weeks and then continued to take Ziprasidone for 10 weeks.The control group still maintain treatment by Olanzapine.To measure waist,systolic pressure,diastolic pressure,FBG,TG,HDL-c,BMI and evaluate the curative effect,adverse reaction of drugs by PANSS and TESS before and in the treatment of 6 and 12 weeks.Results Waist,systolic pressure,BMI and TG in study group were significantly lower than those in control group in treatment of 6 weeks and these indicators continued to decline in treatment of 12 weeks（P0.001）,FBG also declined in treatment of 12 weeks.There were significant differences between two groups（P0.05）.The scores of PANSS and TESS had no significant differences between two groups in treatment of 6 and12 weeks（P0.05）.Conclusion It is an effective countermeasures to improve MS by using Ziprasidone instead of Olanzapine to patients with schizophrenia associated with MS.