瑞波西汀对氯氮平所致代谢综合征及患者生活质量的影响

Effect of reboxetine on clozapine--induced metabolism syndrome and for quality of life

目的观察瑞波西汀对氯氮平所致代谢综合征的改善作用，以及对慢性精神分裂症患者生活质量的影响。方法将110例男性慢性精神分裂症患者分为研究组和对照组各55例，疗程24周，分别于治疗前及治疗后24周末测定体重、BMI、腰围、臀围、wHR、空腹血糖、血脂、血浆胰岛素（INS）水平等指标，采用生活质量综合评定问卷（GQOLI-74）评定对生活质量改善情况；以不良反应量表（TESS）评定不良反应。结果治疗24周后，研究组体重、体重指数（BMI）、腰围、臀围、腰臀比（wHR）、TG、TC、LDL、VLDL、血浆胰岛素（INS）均低于治疗前，HDL高于治疗前，治疗前后比较差异有统计学意义，与对照组比较差异亦有统计学意义（P〈0．05），血糖无明显改变。GQOLI-74躯体健康维度、心理功能维度、社会功能维度及总分得分均高于对照组，差异有统计学意义（P〈o．01）。研究组失眠、便秘、出汗患者比例高于对照组，差异有统计学意义（P〈0．05）。结论瑞波西汀可有效改善氯氮平所致的代谢综合征，提高慢性精神分裂症患者的生活质量。

Objective To study the efficacy of reboxetine in treating clozapine--induced metabo- lism syndrome and quality of life in schizophrenia patients. Methods In this randomized study, 110 male inpatients with chronic schizophrenia in our hospital were included and divided into two treatment groups, one with reboxetine plus clozapine （n = 55） and one with placebo plus clozapine （n = 55）. At the baseline and Z4 weeks after treatment, body mass, body mass index （BMI）, waist circumference, hip circumference, waist-- hip ratio （WHR）, fasting blood glucose （ FBG）, triglycerides （ TG）, cholesterol （TC）, high-- density lipoprotein （ HDL）, low-- density ltpoprotein （LDL）, and insulin （INS） were meas- ured. Quality of life was assessed with General Quality Of Life Inventory-74 （GQOLI-74）. The side effect was assessed with Treatment Emergent Symptom Scale（TESS）. Results After 24-week treat- ment, there was a significant decrease of body mass, BMI, waist circumference, hip circumference, WHR,TG,TC,LDL,VLDL,INS and an increase in HDL in research group from baseline （P〈0.05）. The change was significant comparing to that in placebo treatment group （P〈0.05）. There was no significant change of FBS in each group from baseline to week 24 （P 〈0.05）. GQOLI-74 score of body health,mental health,social function and total score was higher than placebo group （P〈0.01）. Conclusions The results suggest that reboxetine is effective and safe in treatment of clozapine--induced metabolism syndrome. It is beneficial in improving the qualities of life of schizophrenic patients.