齐拉西酮与利培酮对首发精神分裂症患者代谢综合征的影响

Effects of ziprasidone and risperidone on metabolic syndrome for patients with first- episode schizophrenia

目的:分析齐拉西酮与利培酮对首发精神分裂症患者的疗效及代谢综合征的影响。方法:符合首发精神分裂症患者随机分成两组,分别于入组时、治疗第1、3、6个月末,采用阳性和阴性症状量表(PANSS)和临床总体印象量表(CGI-S)评定疗效并相应检测患者体重指数(BMI)、血压、腰围、空腹血糖(FBS)、总胆固醇(CHO)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)等。结果:两组患者治疗同期比较差异无统计学意义(P>0.05);治疗第6个月后与各基线期PANSS和CGI-S评分相比,差异均有显著性(P<0.01)。齐拉西酮组,入组时和治疗6个月后患者发生代谢综合征人数分别为6例(9.68%)和7例(11.29%),改变不显著;利培酮组分别为5例(8.33%)和8例(13.33%),其中体重指数(BMI)、总胆固醇(CHO)、甘油三脂(TG)均较治疗前升高,差异有统计学意义(P<0.05)。结论:齐拉西酮和利培酮治疗首发精神分裂症患者的疗效相当,同时存在患者代谢异常的改变,但齐拉西酮组患者影响轻微。

ObjectiveTo explore and analyze effects of ziprasidone and risperidone on metabolic syndrome for patients withfirst-episode schizophrenia. Methods：The patients with first episode schizophrenia were randomly divided into two groups. Body massindex （BMI）, blood pressure, waist circumference, and the levels of total cholesterol （CHO）, triglyceride （TG）, high-density lipo-protein （HDL）, low density lipoprotein（LDL）, fasting blood sugar （FBS）, postprandial blood sugar （PPBS） and glycosylated hemo-globin （HbA1c） were measured on admission and 1, 3, and 6 months after the treatment. The curative effects were assessed by posi-tive and negative syndrome scale （PANSS） and clinical global impression scale （CGI-S）. Results： There were no significant differ-ences between two groups at the same stage of the treatment （P〉0. 05）. For the PANSS and CGI-S scores, the differences between thebaseline phase and 6 months after the treatment of the two groups were statistically significant （P〈0. 01）. There were 6 cases （9.68%） and 7 cases （11. 29%） with metabolic syndrome in ziprasidone group on admission and 6 months after the treatment, and thedifference was insignificant; whereas there were 5 cases （8. 33%） and 8 cases （13. 33%） with metabolic syndrome in risperidonegroup. BMI and the CHO and TG levels increased compared with those before the treatment, and the differences had statistical signifi-cance （P〈0. 05）. Conclusions： Ziprasidone and risperidone in the treatment of the patients with first-episode schizophrenia have thesimilar curative effects and can improve abnormal metabolism, but ziprasidone is milder.