帕利哌酮与利培酮对首发男性精神分裂症患者糖脂代谢影响的对照研究

A Comparative Study of the Effects of Paliperidone and Risperidone on the Glucose and Lipid Metabolism in First-Episode Male Schizophrenia Patients

目的比较帕利哌酮与利培酮对首发男性精神分裂症患者血糖和血脂代谢的影响。方法 80例首发男性精神分裂症患者随机分为帕利哌酮组(n=40)和利培酮组(n=40),分别给以帕利哌酮缓释片和利培酮片口服,检测入组时和治疗4、8周后两组空腹血糖、胰岛素、C肽、胆固醇、甘油三酯,测定身高、体质量,计算出体质指数,及评定入组时和治疗2、4、8周后两组的PANSS分值。结果帕利哌酮与利培酮的疗效比较差异无统计学意义(P>0.05)。治疗8周后,利培酮组患者的体质指数、胰岛素、C肽、胆固醇、甘油三酯升高,而帕利哌酮则改变不显著。两组治疗前后的空腹血糖值比较,差异无统计学意义。结论帕利哌酮对首发男性精神分裂症血糖、血脂的影响小于利培酮。

OBJECTIVE To compare the effects of paliperidone and risperidone on the glucose and lipid metabolism in first-episode male schizophrenia patients. METHODS Eighty first-episode male schizophrenics were randomly divided into paliperidone group （ n = 40） and risperidone group （ n = 40）. They were treated with paliperidone ER and risperidone respectively. Before and 4 and 8 weeks after the treatment, the height, bodyweight, fasting blood glucose, fasting insulin, C-peptide, cholesterol and triglyceride were measured. In addition, the body mass index were calculated, and the antipsychotic efficacy was evaluated using positive and negative symptom syndrome scale （PANSS） before and 2, 4, and 8 weeks after the treatment. RESULTS After 8 weeks treatment, paliperidone was as effec- tive as risperidone（P 〉 0. 05 ）. The fasting insulin, C- peptide, cholesterol, triglyceride and the body mass index in risperidone group were higher than those before treatment. But in paliperidone group, there was no difference before and after treatment. CONCLUSION Paliperidone has fewer effects on the glucose and lipid metabolism in first-episode male schizophrenia patients than risperidone.