奥氮平与利培酮治疗精神分裂症所致代谢综合征对照研究

A control of schizophrenia ’ s metabolic syndrome caused by olanzapine and risperidone

目的：探讨奥氮平与利培酮治疗精神分裂症导致代谢综合征的发生状况。方法将86例精神分裂症患者随机分成两组，分别口服奥氮平及利培酮治疗，观察12周。于治疗前后采用阳性与阴性症状量表评定精神症状，同时检测血压、身高、体质量、腰围及空腹血糖、血脂水平的变化。结果治疗后两组阳性与阴性症状量表评分均较治疗前显著下降（ P＜0．05或0．01），治疗各时段两组评分比较差异均无显著性（P＞0．05）。治疗后两组体质量及体质量指数均较治疗前显著增加，空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白水平均较治疗显著升高，高密度脂蛋白较治疗前显著下降，治疗8周末起差异均有显著性（ P＜0．05或0．01）；同期两组间各项指标比较差异均无显著性（ P＞0．05）。治疗12周末两组腰围超标，空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白水平升高，高密度脂蛋白水平降低，代谢综合征检出率比较差异均无显著性（P＞0．05）。结论奥氮平与利培酮治疗精神分裂症疗效相当，但对患者的糖脂代谢均有不同程度的影响，均存在发生代谢综合征的风险，临床治疗中应密切监视各项代谢指标的变化。

Objective To explore schizophrenia’s metabolic syndromes caused by olanzapine and risperi-done .Methods Eighty-six schizophrenics were randomly assigned to two groups taking orally olanzapine or risperidone for 12 weeks .Mental symptoms were assessed with the Positive and Negative Syndrome Scale （PANSS） before and after treatment and changes of BP ,body height （BH） ,body mass （BM） ,waist circumference （WC） ,fasting blood sugar （FBS） and blood fit （BF） detected simultaneously .Results Af-ter treatment the PANSS scores of both groups lowered more significantly compared with pretreatment （P〈0 .05 or 0 .01） ,those had no significant group differences in each period of treatment （P〉0 .05） .Af-ter treatment BM and BMI of both groups increased more significantly ,FBS ,triacylglycerol ,total choles-terol （TC） ,LDL levels heightened and HDL lowered ,and differences had significances since the end of the 8th week （P〈0 .05 or 0 .01） .In the corresponding period all indexes had no significant group differences （P〉0 .05） .There were no significant group differences in over-standard WC ,the elevation of FBS ,tria-cylglycerol .TC and LDL ,the reduction of HDL and the detection rate of metabolic syndrome （P〉0 .05） . Conclusion Olanzapine and risperidone have therapeutic equivalence in schizophrenia ,different influences on patients’ glucose and lipid metabolism and the risk of causing metabolic syndromes ,so clinically all metabolic indexes should be closely watched .